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KMID : 0371320020620020133
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Journal of the Korean Surgical Society
2002 Volume.62 No. 2 p.133 ~ p.138
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Experience of Catheter Implantation for Continuous Ambulatory PeritonealDialysis and Catheter Related Complications
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Kwak Jung-Myun
Jung Suk-In
Min Youn-Ki
Kang Seok-Hyung
Joh Yong-Geul
Cho Min-Young
Song Tae-Jin
Lee Jae-Bok
Bae Jung-Won
Seo Seong-Ok
Kim Young-Chul
Whang Jeong-Woong
Cho Won-Yong
Kim Hyung-Kyu
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Abstract
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Purpose: By virtue of advances in scientific methods and technical
systems, there has been a rapid growth in the number of end stage renal
disease (ESRD) patients treated using continuous ambulatory peritoneal
dialysis (CAPD) as their primary renal replacement therapy. However, there
are various catheter related complications that are limiting factors in
patient and catheter maintenance. This study was aimed at introducing of the
techniques of CAPD catheter implantation designed for reducing the
complication rate, as well as conducting an investigation of the incidence
of CAPD catheter related complications and patient survival and catheter
survival rates. Methods: We performed 234 cases of CAPD catheter
implantation using a conventional surgical method (n=162, between January
1993 and December 1997) or a modified surgical method (n=72, between January
1998 and December 1999), and retrospectively reviewed the patient’s medical
records to elucidate the incidence of early catheter related complications
and the catheter removal rate in relation to the surgical methods.
Results: There were 21 cases (23.8%) of peritonitis in the modified
group, which was less than that in the conventional group (79 cases, 48.8%)
(P=0.036). There were 9 cases (12.5%) of exit site and tunnel infection in
the modified group, which was less than that in the conventional group (36
cases, 22.2%) (P=0.019). We were able to reduce the peritonitis as well as
exit site and tunnel infection by a long segment of tunneling and
immobilization of the catheter to the skin. Nine cases of leakage (5.5%)
have occurred in the conventional group and one case (1.3%) in the modified
group; the difference was statistically significant (P=0.046).
Conclusion: These results indicate that our modified surgical methods
can reduce the rate of early catheter related complications.
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KEYWORD
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