Peritoneal dialysis catheter placement, outcomes and complications

Melanie B. LaPlant, Daniel A Saltzman, Bradley J Segura, Robert D Acton, Brad A. Feltis, Donavon J Hess

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Purpose: Peritoneal dialysis (PD) is a commonly used method for renal support in pediatric patients and can be associated with the risk of post-surgical complications. We evaluated method of placement of PD catheters with regard to post-surgical complications. Methods: PD catheters placed at two institutions between 2005 and 2017 were reviewed. Complication rates were evaluated based on method of placement, delayed usage, omentectomy, and patient age using Fisher’s exact test, two-sided, with significance set at 0.05. Factors influencing complication were evaluated with multivariate logistic regression and Kaplan–Meier survival analysis. Results: There were 130 patients with 157 catheters placed, ranging in age from 1 day to 23 years. There was no significant difference in complication rate by method of placement or delayed usage. Infants were significantly more likely to experience leakage (21% vs 8%, p 0.036) and hernias (15% vs 5%, p 0.030). Patients that underwent an omentectomy were less likely to require a catheter replacement (7% vs 27%, p 0.004), and the catheters had a significantly higher survival rate (p 0.009). We found that laparoscopic intervention resulted in catheter salvage. Lateral exit sites may be a risk factor for catheter migration in some patients. Conclusions: Omentectomy is associated with longer PD catheter survival. Laparoscopic salvage of dysfunctional catheters may be a valuable adjunct in management.

Original languageEnglish (US)
Pages (from-to)1239-1244
Number of pages6
JournalPediatric Surgery International
Volume34
Issue number11
DOIs
StatePublished - Nov 1 2018

Keywords

  • Laparoscopic
  • Laparoscopic salvage
  • Omentectomy
  • Pediatric
  • Peritoneal dialysis

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