Outcomes after peritoneal dialysis catheter placement.

Abstract:

BACKGROUND:The purpose of this study was to review surgical outcomes after elective placement of peritoneal dialysis (PD) catheters in children with end-stage renal disease. METHODS:Children with PD catheters placed between February 2002 and July 2014 were retrospectively reviewed. Outcomes were catheter life, late (>30days post-op) complications (catheter malfunction, catheter malposition, infection), and re-operation rates. Comparison groups included laparoscopic versus open placement, age<2, and weight<10kg. Univariate and multivariate analysis were performed. RESULTS:One hundred sixteen patients had 173 catheters placed (122 open, 51 laparoscopic) with an average patient age of 9.7±6.3years. Mean catheter life was similar in the laparoscopic and open groups (581±539days versus 574±487days, p=0.938). The late complication rate was higher for open procedures (57% versus 37%, p=0.013). Children age<2 or weight<10kg had higher re-operation rates (64% versus 42%, p=0.014 and 73% versus 40%, p=0.001, respectively). Adjusted for age and weight, open technique remained a risk factor for late complications (OR 2.44, 95% CI 1.20-4.95) but not re-operation. DISCUSSION:Laparoscopic placement appears to reduce the rate of late complications in children who require PD dialysis catheters. Children <2years age or <10kg remain at risk for complications regardless of technique.

journal_name

J Pediatr Surg

authors

Carpenter JL,Fallon SC,Swartz SJ,Minifee PK,Cass DL,Nuchtern JG,Pimpalwar AP,Brandt ML

doi

10.1016/j.jpedsurg.2016.02.011

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

730-3

issue

5

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(16)00074-9

journal_volume

51

pub_type

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