Is peritoneoscopic-assisted Tenckhoff Catheter Insertion safe and effective in our nephrologists' hand?

Ahmad, MK and Seman, Mohd Ramli and Draman, Che Rosle and Wan Ali, Wan Ahmad Syahril Rozli and Ramli, Norazsida (2013) Is peritoneoscopic-assisted Tenckhoff Catheter Insertion safe and effective in our nephrologists' hand? In: 29th Annual Congress of the Malaysian Society of Nephrology, 21–23 June 2013, Persada Convention Centre, Johor Bharu, Johor. (Unpublished)

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Abstract

Background: The practice of peritoneal dialysis (PD) catheter insertion by nephrologists has been advo¬cated to enhance PD penetration with encouraging outcome as shown in several centres. In this study, we evaluate the safety and effectiveness of our catheter insertion via peritoneoscopic method. Methods: We report our local experience in tenchkoff catheter insertion using the Y Tec peritoneoscopic method. Data were collected retrospectively from March 2011 to June 2012, for patient’s characteristics, procedural complications, and catheter outcome. Results: A total of 41 catheters were inserted by nephrologist and trainees. Majority of patients were diabetics (58.5%) with mean age of 57.44 ± 14.40 years. Primary catheter failure, as defined by catheters that failed to function within 1 month after insertion, occurred in 6 (14.6%) of cases. Of those 6 cases, 4 experienced mechanical problems and 2 involved bowel injury. 2 of patients experienced mechanical problems resumed peritoneal dialysis after the catheter was replaced and repositioned, however the other 2 patients converted to hemodialysis. Complications from small-bowel injury were recognized in 2 patients, 1 of each occurred intraoperatively and postoperatively; both underwent laparotomy for bowel repair. No mortality was at¬tributable to Tenckhoff catheter insertion. In our series of patients, the major cause of peritoneal catheter failure was infectious complications secondary to perito¬nitis, 6 (14.6%). Mean technique survival for the catheters was 5.37 ± 4.58 (95%CI). Diabetic patients seemed to have shorter catheter survival compared to non-diabetics, however it was not different statistically; p 0.5. The 6-month and 1-year catheter survival rates were 67% and 48% respectively. Conclusions: We showed an acceptable primary catheter outcome and safety profiles, with the needs for continuous learning as well as monitoring of operators performance for better catheter survival. References: Asif A, Pflederer TA, Vieira CF, Diego J, Roth D, Agarwal A. Does catheter insertion by nephrologists improve perito¬neal dialysis utilization? A multicenter analysis. Semin Dial 2005; 18:157–60. Li PK, Chow KM. Importance of peritoneal dialysis cath¬eter insertion by nephrologists: practice makes perfect. Nephrol Dial Transplant 2009; 24:3274–6.

Item Type:	Conference or Workshop Item (Poster)
Additional Information:	5229/58981
Subjects:	R Medicine > R Medicine (General)
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Internal Medicine Kulliyyah of Allied Health Sciences Kulliyyah of Allied Health Sciences > Department of Biomedical Science (Effective:1st July 2011) Kulliyyah of Medicine
Depositing User:	Dr. Wan Ahmad Syahril Rozli Wan Ali
Date Deposited:	23 Nov 2017 14:15
Last Modified:	19 May 2021 13:05
URI:	http://irep.iium.edu.my/id/eprint/58981

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