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KMID : 0978820080110020145
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2008 Volume.11 No. 2 p.145 ~ p.150
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A Comparison of the Laparoscopic Method versus the Traditional Open Method for Continuous Ambulatory Peritoneal Dialysis Catheter Insertion
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Chang Tae-Young
Kang Jin-Mo
Park Yang-Jin
Yun Ik-Jin
Min Seung-Kee
Ha Jong-Won
Kim Sang-Joon
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Abstract
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Purpose: Continuous ambulatory peritoneal dialysis (CAPD) is an important method of renal replacement therapy for patients with chronic renal failure. A significant number of complications and catheter failures in CAPD are due to mechanical problems and peritonitis. Secure, correct positioning of the catheter is important to minimize the risk. The purpose of this study is to compare the clinical outcomes of two different CAPD catheter insertion techniques, that is, the laparoscopic method versus the traditional open technique.
Methods: We reviewed a total of 96 consecutive cases of CAPD catheter insertion that were performed at Seoul National University Hospital from January 2004 to December 2005 (laparoscopic: 52, open: 44). The data was retrospectively collected using the medical records to determine the clinical results and the catheter-related complication.
Results: There was no case of catheter obstruction in the laparoscopic group, but there was 1 case in the open group. There were 6 cases of catheter migration in each group. There were 12 cases of peritonitis in the laparoscopic group and 7 cases in the open group. There were 7 cases of exit site infection in the laparoscopic group and 5 cases in the open group. There were 8 cases of incisional hernia in the laparoscopic group and 2 cases in open group. There were 2 cases of peritosol leakage in the laparoscopic group and 1 case in the open group. The incidence of complication was not statistically different between the groups.
Conclusion: The laparoscopic technique showed a similar mechanical complication rate compared to the open technique. Incisional hernia developed more frequently in the laparoscopic group, and incisional hernia requires more careful closure technique.
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KEYWORD
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Continuous ambulatory peritoneal dialysis, Peritoneal dialysis, Laparoscopy
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