Moncrief-Popovich technique is an advantageous method of peritoneal dialysis catheter implantation

被引:19
作者
Brum, Sandra [1 ]
Rodrigues, Anabela [1 ,5 ]
Rocha, Sofia [1 ]
Carvalho, Maria Joao [1 ,5 ]
Nogueira, Carlos [2 ]
Magalhaes, Carlos [3 ]
Mendonca, Denisa [4 ,6 ]
Cabrita, Antonio [1 ]
机构
[1] CHP Hosp Santo Antonio, Dept Nephrol, P-4000 Oporto, Portugal
[2] CHP Hosp Santo Antonio, Dept Surg, P-4000 Oporto, Portugal
[3] CHP Hosp Santo Antonio, Ambulatory Surg Dept, P-4000 Oporto, Portugal
[4] Univ Porto, Dept Biostat, ICBAS, P-4100 Oporto, Portugal
[5] Univ Porto, ICBAS, UMIB, P-4100 Oporto, Portugal
[6] Univ Porto, Inst Publ Hlth, P-4100 Oporto, Portugal
关键词
Moncrief-Popovich technique; peritoneal dialysis; peritoneal dialysis catheter;
D O I
10.1093/ndt/gfq142
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
Background. A safe and well-functioning peritoneal catheter is fundamental for adequate peritoneal dialysis (PD) treatment. Peritoneal catheter implantation by Moncrief-Popovich (MP) technique might add several clinical advantages besides allowing timely access implantation. The aim of this study was to investigate the rate of catheter-related complications and survival in a single-centre university hospital PD unit, according to the method of catheter implantation. Methods. Four hundred and sixty-seven consecutive Tenckhoff catheters were implanted after antibiotic prophylaxis in an operating room: surgical mini-laparotomy (ML) was used in 211(45%), Seldinger technique (S) in 76 (16%) and mini-laparotomy with MP method in 180 (38.5%). Results. The MP technique was significantly associated with a lower rate of early exit-site infection (ESI) (P = 0.02), lower rate of leak (P <0.0001) and also lower rate of obstruction (P = 0.034) in spite of prolonged break-in (median 55 days, range 0-991 days). Catheter survival by MP technique was 92%, 83% and 64% at 12, 24 and 60 months, respectively, and significantly superior in comparison with the previous methods (log-rank, P = 0.032). By Cox multivariate analysis, adjusted for age, sex and diabetes, the MP technique remained independently associated with better catheter survival [hazard ratio (HR) 0.587 (0.397-0.870), P = 0.008]. Conclusion. Our experience documented improved PD clinical outcomes with the MP method of catheter implantation while assuring timely access management and logistic advantages.
引用
收藏
页码:3070 / 3075
页数:6
相关论文
共 13 条
  • [1] ALVARO F, 1994, ADV PERIT DIAL, V10, P199
  • [2] Caruso DM, 1997, ADV PERIT D, V13, P183
  • [3] Danielsson A, 2002, PERITON DIALYSIS INT, V22, P211
  • [4] Dombros N., 2005, NEPHROL DIAL TRANSPL, DOI [10.1093/ndt/gfi1117, DOI 10.1093/NDT/GFI1117]
  • [5] Freitas Cristina, 2009, Adv Perit Dial, V25, P26
  • [6] Does Peritoneal Dialysis Catheter Insertion by Interventional Nephrologists Enhance Peritoneal Dialysis Penetration?
    Goh, Bak Leong
    Ganeshadeva, Yudisthra M.
    Chew, Siew Eng
    Dalimi, Mohd Sulaiman
    [J]. SEMINARS IN DIALYSIS, 2008, 21 (06) : 561 - 566
  • [7] Predictors of the rate of decline of residual renal function in incident dialysis patients
    Jansen, MAM
    Hart, AAM
    Korevaar, JC
    Dekker, FW
    Boeschoten, EW
    Krediet, RT
    [J]. KIDNEY INTERNATIONAL, 2002, 62 (03) : 1046 - 1053
  • [8] Moncrief J, 1993, Perit Dial Int, V13 Suppl 2, pS127
  • [9] Moncrief J.W., 1993, Peritoneal Dialysis International, V13, P329
  • [10] MONCRIEF JW, 1991, PERITON DIALYSIS INT, V11, pS180