Continuous ambulatory peritoneal dialysis catheter insertion by open technique: 20-year experience from a single center
Introduction: Continuous ambulatory peritoneal dialysis (CAPD) catheter placement is a part of renal replacement therapy. We describe our 20-year experience in using the open technique and assess its safety, efficacy, and outcome in the treatment of end-stage renal disease patients. Methods: In a re...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Indian Journal of Urology |
| Online Access: | http://www.indianjurol.com/article.asp?issn=0970-1591;year=2023;volume=39;issue=1;spage=46;epage=52;aulast=Pahwa |
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| author | Mrinal Pahwa Mahendra Singh Vipin Tyagi Manu Gupta Saurabh Jain Sudhir Chaddha Harsha Jauhari |
| author_facet | Mrinal Pahwa Mahendra Singh Vipin Tyagi Manu Gupta Saurabh Jain Sudhir Chaddha Harsha Jauhari |
| author_sort | Mrinal Pahwa |
| collection | DOAJ |
| description | Introduction: Continuous ambulatory peritoneal dialysis (CAPD) catheter placement is a part of renal replacement therapy. We describe our 20-year experience in using the open technique and assess its safety, efficacy, and outcome in the treatment of end-stage renal disease patients.
Methods: In a retrospective study, we analyzed data of all patients who had a CAPD catheter placed using our open dissection technique using local anesthesia over the previous 20 years, with minimum 1 year of follow-up. Intraoperative data, postoperative data, and complications were noted.
Results: A total of 1410 cases were included in the study. The mean duration of follow-up was 72 ± 18 months (range 12–120 months). The mean operative time was 19 ± 7.5 min and mean hospital stay was 3 ± 1 days. No major intraoperative complications were noted. We observed a peritonitis rate of 0.49 episodes/patient/year. The most common reason for permanent catheter removal was refractory peritonitis in 21%, followed by flow failure in 7%, and ultrafiltration failure in 6.5%. The death-censored technical survival rate was 94.3%, 83.2%, 75.9%, 69.2%, and 60.6% patients at 1 year, 2 years, 3 years, 4 years, and 5 years, respectively.
Conclusions: The open dissection method of peritoneal dialysis catheter insertion using local anesthesia at well-experienced center is a simple, painless, and uncomplicated procedure with excellent outcomes. Optimal exposure, judicious use of energy source, and using appropriate technique provide good technical success rate with lesser complications. |
| first_indexed | 2024-04-10T23:26:09Z |
| format | Article |
| id | doaj.art-3911b8a393b9482fa533d9d0f4145e49 |
| institution | Directory Open Access Journal |
| issn | 0970-1591 1998-3824 |
| language | English |
| last_indexed | 2024-04-10T23:26:09Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Urology |
| spelling | doaj.art-3911b8a393b9482fa533d9d0f4145e492023-01-12T12:11:39ZengWolters Kluwer Medknow PublicationsIndian Journal of Urology0970-15911998-38242023-01-01391465210.4103/iju.iju_156_22Continuous ambulatory peritoneal dialysis catheter insertion by open technique: 20-year experience from a single centerMrinal PahwaMahendra SinghVipin TyagiManu GuptaSaurabh JainSudhir ChaddhaHarsha JauhariIntroduction: Continuous ambulatory peritoneal dialysis (CAPD) catheter placement is a part of renal replacement therapy. We describe our 20-year experience in using the open technique and assess its safety, efficacy, and outcome in the treatment of end-stage renal disease patients. Methods: In a retrospective study, we analyzed data of all patients who had a CAPD catheter placed using our open dissection technique using local anesthesia over the previous 20 years, with minimum 1 year of follow-up. Intraoperative data, postoperative data, and complications were noted. Results: A total of 1410 cases were included in the study. The mean duration of follow-up was 72 ± 18 months (range 12–120 months). The mean operative time was 19 ± 7.5 min and mean hospital stay was 3 ± 1 days. No major intraoperative complications were noted. We observed a peritonitis rate of 0.49 episodes/patient/year. The most common reason for permanent catheter removal was refractory peritonitis in 21%, followed by flow failure in 7%, and ultrafiltration failure in 6.5%. The death-censored technical survival rate was 94.3%, 83.2%, 75.9%, 69.2%, and 60.6% patients at 1 year, 2 years, 3 years, 4 years, and 5 years, respectively. Conclusions: The open dissection method of peritoneal dialysis catheter insertion using local anesthesia at well-experienced center is a simple, painless, and uncomplicated procedure with excellent outcomes. Optimal exposure, judicious use of energy source, and using appropriate technique provide good technical success rate with lesser complications.http://www.indianjurol.com/article.asp?issn=0970-1591;year=2023;volume=39;issue=1;spage=46;epage=52;aulast=Pahwa |
| spellingShingle | Mrinal Pahwa Mahendra Singh Vipin Tyagi Manu Gupta Saurabh Jain Sudhir Chaddha Harsha Jauhari Continuous ambulatory peritoneal dialysis catheter insertion by open technique: 20-year experience from a single center Indian Journal of Urology |
| title | Continuous ambulatory peritoneal dialysis catheter insertion by open technique: 20-year experience from a single center |
| title_full | Continuous ambulatory peritoneal dialysis catheter insertion by open technique: 20-year experience from a single center |
| title_fullStr | Continuous ambulatory peritoneal dialysis catheter insertion by open technique: 20-year experience from a single center |
| title_full_unstemmed | Continuous ambulatory peritoneal dialysis catheter insertion by open technique: 20-year experience from a single center |
| title_short | Continuous ambulatory peritoneal dialysis catheter insertion by open technique: 20-year experience from a single center |
| title_sort | continuous ambulatory peritoneal dialysis catheter insertion by open technique 20 year experience from a single center |
| url | http://www.indianjurol.com/article.asp?issn=0970-1591;year=2023;volume=39;issue=1;spage=46;epage=52;aulast=Pahwa |
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