Risk factors for morbidity and mortality in pediatric patients with peritoneal dialysis catheters

被引:29
作者
Phan, Jennifer [1 ]
Stanford, Steve [1 ]
Zaritsky, Joshua J. [1 ]
DeUgarte, Daniel A. [1 ]
机构
[1] Univ Calif Los Angeles, David Geffen Sch Med, Div Pediat Surg, Los Angeles, CA 90095 USA
关键词
Peritoneal dialysis; Pediatric; Omentectomy; Laparoscopy; Gastrostomy; Reoperation; SINGLE-CENTER EXPERIENCE; CHILDREN; OMENTECTOMY; COMPLICATIONS; PLACEMENT; INFANTS;
D O I
10.1016/j.jpedsurg.2012.10.035
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Purpose: As peritoneal dialysis (PD) is the preferred long-term dialysis modality in the pediatric population, we sought to identify risk factors for mortality and reoperation. Methods: A retrospective review of patients undergoing PD catheter insertions at a single center from 1994-2009 was performed. The following variables were evaluated: age (< 1 year), comorbidities, omentectomy, concomitant gastrostomy, and laparoscopic technique. Multivariable Cox regressions analyses were used to evaluate patient survival and reoperation-free survival of PD catheters. Results: 207 patients with a median age of 10 years underwent PD insertion. Mortality was 7% with a median follow up of 72 months. Reoperation for malfunction and infection was required in 49% of patients with a median PD catheter survival of 11 months. Reoperation for hernias occurred in 14% of patients. Multivariate Cox regressions analyses identified age < 1 year, lack of omentectomy, concomitant gastrostomy, and prematurity as variables significantly associated with higher rates of mortality or reoperation. Conclusions: In this large study of pediatric patients undergoing PD, higher complication rates were noted in infants less than one year of age. Concomitant gastrostomy was associated with a higher rate of reoperation for infection. Failure to perform omentectomy was associated with a higher rate of catheter failure. (C) 2013 Elsevier Inc. All rights reserved.
引用
收藏
页码:197 / 202
页数:6
相关论文
共 19 条
  • [1] Agalar F, 1997, EUR J SURG, V163, P605
  • [2] [Anonymous], 2009, AM J KIDNEY DIS, V53, pS11
  • [3] Advanced Laparoscopic Techniques Significantly Improve Function of Peritoneal Dialysis Catheters
    Attaluri, Vikram
    Lebeis, Christopher
    Brethauer, Stacy
    Rosenblatt, Steven
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2010, 211 (06) : 699 - 704
  • [4] Surgical aspects of dialysis in newborns and infants weighing less than ten kilograms
    Beanes, SR
    Kling, KM
    Fonkalsrud, EW
    Torres, M
    Salusky, IB
    Quinones-Baldrich, WJ
    Atkinson, JB
    [J]. JOURNAL OF PEDIATRIC SURGERY, 2000, 35 (11) : 1543 - 1548
  • [5] Selective performance of prophylactic omentopexy during laparoscopic implantation of peritoneal dialysis catheters
    Crabtree, JH
    Fishman, A
    [J]. SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES, 2003, 13 (03) : 180 - 184
  • [6] Risk factors for early peritoneal dialysis catheter failure in children
    Cribbs, Randolph K.
    Greenbaum, Larry A.
    Heiss, Kurt F.
    [J]. JOURNAL OF PEDIATRIC SURGERY, 2010, 45 (03) : 585 - 589
  • [7] Prospective Randomized Study for Comparison of Open Surgery with Laparoscopic-Assisted Placement of Tenckhoff Peritoneal Dialysis Catheter-A Single Center Experience and Literature Review
    Jwo, Shyh-Chuan
    Chen, Kuo-Su
    Lee, Chin-Chan
    Chen, Huang-Yang
    [J]. JOURNAL OF SURGICAL RESEARCH, 2010, 159 (01) : 489 - 496
  • [8] Impact of primary omentectomy on longevity of peritoneal dialysis catheters in children
    Ladd, Alan P.
    Breckler, Francine D.
    Novotny, Nathan M.
    [J]. AMERICAN JOURNAL OF SURGERY, 2011, 201 (03) : 401 - 405
  • [9] Primary laparoscopic placement of peritoneal dialysis catheters in children and young adults
    Lessin, MS
    Luks, FI
    Brem, AS
    Wesselhoeft, CW
    [J]. SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES, 1999, 13 (11): : 1165 - 1167
  • [10] Chronic peritoneal dialysis in children:: catheter related complications.: A single centre experience
    Macchini, Francesco
    Valade, Alberto
    Ardissino, Gianluigi
    Testa, Sara
    Edefonti, Alberto
    Torricelli, Maurizio
    Luzzani, Sergio
    [J]. PEDIATRIC SURGERY INTERNATIONAL, 2006, 22 (06) : 524 - 528