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Sürekli Ayaktan Periton Diyalizi Hastalarında Kateter Takma Yönteminin Teknik Sağ Kalım Üzerine Etkileri

The Effect of Catheter Placement Technique on Technical Survival in Patients Receiving Continuous Ambulatory Peritoneal Dialysis

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DOI: 
DOI 10.5262/tndt.2010.1003.08
Abstract (2. Language): 
Objective : The effect of the catheter placement method on technical survival was evaluated in patients receiving peritoneal dialysis and followed in our Nephrology Department. Materi al and Metho ds: Catheter placement method and functions were assessed retrospectively from medical records of 313 patients. Peritoneal catheter placement was achieved by the percutaneous technique in 220 (70.3%) patients and by the surgical technique in 93 (29.7%) patients. Res ults : Technical survival rates were 89.1%, 84% and 74.1% in the first, third and fifth year, respectively. The technique complication incidence was higher in patients where the catheter were placed percutaneously (31.3%) than those who had undergone surgical catheter placement (19.5%) (p=0.27). Incidence of exit site infection was lower in patients who were catheterized by the percutaneous technique (20.1.%) than those catheterized by the surgical technique (47.3%) (p<0.001). Herniation incidence was lower in patients where the catheter was placed percutaneously (3.6%) than surgically (17.2%) (p=0.001). There was no relationship between catheter placement method and peritonitis, leakage or revision requirement. Conclusion: Our results indicate that the catheter placement method could improve patient comfort and reduce cost by altering the frequency of technical complications and exit site infection. Catheter placement by the percutaneous route can be achieved safely and effectively by experienced nephrologists.
Abstract (Original Language): 
Amaç: Bu çalışmada Hastanemiz Nefroloji kliniğinde izlenen periton diyaliz hastalarında teknik sağkalıma kateter takma yönteminin etkisi araştırıldı. Gereç ve Yönte mler : 313 hastanın kayıtları incelenerek kateter takma yöntemleri ve kateter işlevleri geriye dönük olarak değerlendirildi. Hastalardan 220’sine (%70,3) perkutan, 93’üne (%29,7) cerrahi yöntemle periton diyaliz kateteri uygulandı. Bulgular: Birinci, üçüncü ve beşinci yılda kateterlerin teknik sağkalım oranı sırasıyla %89,1, %84 ve %74,1 olarak saptandı. Teknik komplikasyon görülme sıklığı perkutan yöntemle kateter takılanlarda (%31,3), cerrahi yöntemle kateter takılanlardan (%19,5) daha fazla saptandı (p=0,027). Çıkış yeri enfeksiyon görülme sıklığı perkutan teknikle kateter takılan hastalarda (%20,1), cerrahi teknikle kateter takılanlardan (%47,3) daha az saptandı (p<0,001). Herni oluşma sıklığı perkutan teknikle kateter takılanlarda (%3,6), cerrahi teknikle kateter takılanlardan (%17,2) daha az bulundu (p=0,001). Kateter takma yöntemi ile peritonit, kaçak, sızıntı, revizyon ihtiyacı arasında ilişki saptanmadı. Sonuç: Bizim sonuçlarımız kateter takma yönteminin teknik komplikasyon ve çıkış yeri enfeksiyon sıklığını değiştirerek hasta maliyet ve konforunu iyileştirebileceğini göstermektedir. Perkutan teknikle periton diyaliz kateteri yerleştirilmesi deneyimli nefrologların ellerinde güvenli ve etkin bir yöntem olarak uygulanabilir.
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