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Sürekli Ayaktan Peritoneal Diyaliz Kateteri Yerleştirilmesinde Uygulanan Laparoskopik ve Klasik Yöntemlerin Komplikasyonları Açısından Karşılaştırılması

Comparison of Laparoscopic and Conventional Methods for Continuous Ambulatory Peritoneal Dialysis Catheter Insertion in Terms of Complications

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2012
DOI: 
DOI 10.5262/tndt.2012.1002.09

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Obj ecti ve: There are various methods for inserting a peritoneal dialysis catheter. Conventional and laparoscopic methods are superior to each other in many different aspects. In this study, both methods were compared with each other in terms of complications. MATER IAL and Methods: Data from 54 patients with end stage renal diseases who were operated for peritoneal dialysis catheter insertion in between 2006 and 2008 at the Department of General Surgery, Faculty of Medicine and University of Akdeniz were analyzed retrospectively. The laparoscopic method was used for 37 patients and the conventional method was used for 17 patients for peritoneal dialysis catheter insertion. While the catheter was placed into pelvis with the aid of a guide wire in the conventional group (CG), it was placed into the pelvis by a camera through a tunnel, formed at preperitoneal field in laparoscopic group (LG). Results : Demographic characteristics of two groups were similar. Median follow up duration was 137 days (range 4 - 678). Functionality rate in one-year for catheters were 87 % in LG and 77 % in CG groups (log rank test p=0.341). Dialysate leakage rates were 19% and 29%, catheter infections rates were 11% and 12% in LG and CG, respectively (p>0.05). However for peritonitis complication, there were significant differences between two groups, 14% and 41% in LG and CG, respectively (p<0.05). Conc lusion : The complications of laparoscopic and conventional surgery methods were compared to place a peritoneal dialysis catheter in the present study. It was observed that among all the compared complications, only the frequency of peritonitis was lower in patients who were operated laparoscopically.
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Abstract (Original Language): 
Amaç : Peritoneal diyaliz kateteri yerleştirilmesinde farklı yöntemler vardır. Geleneksel ve laparoskopik yöntemlerin birçok farklı yönleriyle birbirlerine üstünlükleri vardır. Bu çalışmada, bu iki yöntem komplikasyonları açısından birbiriyle karşılaştırılmıştır. gereç ve Yöntemler: Akdeniz Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilimdalı’ nda 2006-2008 yılları arasında periton diyalizi kateteri yerleştirilmiş 54 hastaya ait veriler geriye dönük olarak analiz edilmiştir. Periton diyalizi katateri yerleştirilmesinde 37 hastada laparoskopik yöntem, 17 hastada ise geleneksel yöntem kullanılmıştır. Klasik yöntemin uygulandığı klasik grupta (KG) kateterin pelvise yerleştirilmesi kılavuz tel yardımı ile sağlanmış iken, laparoskopik yöntemin uygulandığı laparoskopik grupta (LG) ise preperitoneal alandan açılmış bir kanal boyunca ilerleyen kamera ile sağlanmıştır. Bulgular: Her iki gruba ait demografik veriler benzer bulunmuştur. Ortalama izlem süresi 8±7,2 ay olmuştur. LG’a ait kateterlerin % 91,9’ u, KG’ a ait olanların ise % 88,2’ sinin çalışır halde olduğu saptanmıştır (p > 0,05). Diyalizat kaçak oranları LG ve KG için sırasıyla % 18,9 ve % 29,4; kateter enfeksiyon oranları yine sırasıyla % 10.8 ve % 11,8 bulunmuştur (p > 0,05). Ancak, LG için % 13,5 ve KG için % 41,2 olarak saptanan peritonit sıklıkları açısından iki grup arasında anlamlı fark bulunmuştur (p < 0,05). Son uç: Geleneksel ve laparoskopik yöntemlerin komplikasyonları, peritoneal diyaliz kateterinin yerleştirilmesi açısından karşılaştırılmıştır. Karşılaştırılan tüm komplikasyonlar arasında sadece peritonit sıklığının laparoskopi uygulananlarda daha az olduğu gözlemlenmiştir.
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  • 2
156-160
  • Turkish

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