Abstract：
BACKGROUND:With the introduction of laparoscopic Tenckhoff catheter insertion in the early 1990s, catheter malposition resulting in malfunction remains a frequent complication, often requiring surgical or radiological intervention. In this pioneer study, we describe the technique of suturing the Tenckhoff catheter using an EndoClose (Medtronic, Macquarie Park, NSW, Australia) device to the anterior abdominal wall during laparoscopic insertion and compare its outcomes with those not sutured. METHODS:This is a retrospective study of all patients who underwent laparoscopic Tenckhoff catheter insertion at Western Health from January 2013 to June 2018. All procedures were undertaken or supervised by one surgeon. The primary outcome was catheter malposition requiring surgical revision. Secondary outcomes were time to malposition and complications. Peri- and post-operative factors were analysed to adjust for confounders using the Cochran-Mantel-Haenszel test. RESULTS:There were 82 patients in the sutured group and 63 patients in the non-sutured group. Catheter malposition occurred in 7.32% in the sutured group and 19.05% in the non-sutured group (P = 0.034; 95% confidence interval for the difference 0.007-0.237). There was an overall reduction in the odds of catheter malposition of 63% in favour of the sutured group. The median time-to-malposition was 128 and 182 days for the non-sutured and sutured group, respectively, but not statistically different. No differences were found for the number of post-operative complications. CONCLUSION:Suturing of Tenckhoff catheter with an EndoClose device to the anterior abdominal wall during laparoscopic insertion is a simple, safe and useful method of reducing catheter malposition.
journal_name
ANZ J Surgjournal_title
ANZ journal of surgeryauthors
Rouse M,Choi J,Bakhit J,Soh B,Chan Sdoi
10.1111/ans.15506subject
Has Abstractpub_date
2020-01-01 00:00:00pages
72-75issue
1-2eissn
1445-1433issn
1445-2197journal_volume
90pub_type
杂志文章abstract：BACKGROUND:Nephron-sparing surgery is currently an accepted treatment for renal cell carcinomas in patients with bilateral tumours, solitary kidneys and when overall renal function is impaired or at risk from medical disease. Its role in patients with a normal contralateral kidney remains controversial. METHODS:The au...
journal_title：ANZ journal of surgery
pub_type： 杂志文章
doi：
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journal_title：ANZ journal of surgery
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journal_title：ANZ journal of surgery
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journal_title：ANZ journal of surgery
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pub_type： 临床试验,杂志文章
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