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- Title
An analysis of the "Half-Perc" versus open surgical placement method for a peritoneal dialysis catheter: a non-inferiority cohort study.
- Authors
Zhang, Difei; Peng, Yu; Zheng, Tingting; Liu, Hui; Wu, Jianfeng; Li, Zewen; Su, Jingxu; Xu, Yuan; Hu, Xiaoxuan; Chen, Guowei; Hou, Haijing; Zhang, La; Wu, Liwen; Liu, Xusheng; Lu, Fuhua
- Abstract
<bold>Background: </bold>Most end-stage renal disease (ESRD) patients undergo open surgical techniques for peritoneal dialysis (PD) catheter placement. An alternative method to PD catheter implantation is the half-percutaneous ("Half-Perc") technique based on a modified trocar that is performed by a nephrologist. The single-center, retrospective, observational, cohort study presented here aimed to compare the effects of the "Half-Perc" technique with the traditional open surgery on peritoneal catheter insertion.<bold>Methods: </bold>From January 2015 to January 2018, 240 ESRD patients who received initial PD catheter placement were divided into two groups based on the "Half-Perc" technique or open surgery. All patients were followed up for 365 days or until loss of initial PD catheter or death. Prism 5 software was used to analyze baseline characteristics, operation-related parameters, mechanical complications and clinical outcomes.<bold>Results: </bold>The "Half-Perc" technique showed shorter operation time, shorter incision length, lower postoperative pain scores and quick initiation of the PD program compared to the open surgery. After the 365-day follow-up, the "Half-Perc" group showed a higher rate of catheter dysfunction (4% versus 0.9%) that was corrected by conservative treatment in most patients and a lower rate of peritonitis (4% versus 9.6%) but mechanical complications and clinical outcomes did not differ between the two groups. There was also no significant difference based on overall patient mortality or catheter removal. One-year initial catheter survival and true catheter survival were not statistically different between the groups.<bold>Conclusion: </bold>The "Half-Perc" placement of the PD catheter using a modified metal trocar appears to be a non-inferior alternative method and carries minimal invasiveness and risk compared to open surgical placement.
- Subjects
DIALYSIS catheters; PERITONEAL dialysis; CATHETERIZATION; CHRONIC kidney failure; COHORT analysis; POSTOPERATIVE pain; TREATMENT of chronic kidney failure; SURGICAL instruments; RESEARCH; ENDOSCOPIC surgery; RESEARCH methodology; RETROSPECTIVE studies; MEDICAL cooperation; EVALUATION research; COMPARATIVE studies; LAPAROSCOPY; RESEARCH funding
- Publication
BMC Nephrology, 2020, Vol 21, Issue 1, p1
- ISSN
1471-2369
- Publication type
journal article
- DOI
10.1186/s12882-020-01936-0