Peritoneal dialysis. catheters: laparoscopic versus traditional placement techniques and outcomes

Background: Peritoneal dialysis is used for renal replacement therapy in over 25,000 patients in the United States. Some authors have recommended laparoscopic guidance for peritoneal dialysis catheter (PDC) placement, although consensus statements have not favored a specific technique. This study reviews outcomes in patients in whom placement was performed by the traditional "blind" technique (B-PDC) versus the laparoscopic technique (L-PDC). Methods: Records were retrospectively reviewed of 25 consecutive PDC patients in each of 3 university-affiliated tertiary medical center hospitals. Data for PDCs placed by B-PDC (n = 30) or L-PDC (n = 45) technique were reviewed and the outcomes compared. Results: L-PDCs offered 97.8% immediate functional success as opposed to 80% with B-PDC placement (P =.014). In addition, laparoscopic placement of peritoneal dialysis catheters had a lower incidence of PDC revision or replacement (P =.035). Conclusion: L-PDCs were found to have a higher immediate functional success rate than B-PDCs and a lower incidence of catheter revision or replacement. (c) 2007 Published by Excerpta Medica Inc.