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J Res Med Sci. 2019 Sep 30;24:85. doi: 10.4103/jrms.JRMS_1097_18. eCollection 2019.

Comparison of the complications of open surgery versus laparoscopic technique in insertion of peritoneal dialysis catheter.

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1
Department of General Surgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background:

Invention of peritoneal dialysis (PD) has opened new windows for patients under dialysis due to its fewer time requirement and being ambulatory in comparison to hemodialysis. Open surgery and laparoscopic technique have been utilized for peritoneal catheter embedding; however, data about the superior technique are controversial. This study aimed to assess the outcomes of open surgery versus laparoscopic technique and compare their complications in those with survival of over and less than a year in patients who need PD for the first time.

Materials and Methods:

This randomized clinical trial study was conducted on 121 cases admitted for PD. Patients were randomly divided into two groups undergoing either open or laparoscopic surgery for embedding PD catheter. Patients' demographics, as well as PD function and complications, were followed for a 12-month duration and compared between the two groups.

Results:

Catheter survival for over 12 months occurred in 39 patients (65%) underwent laparoscopic surgery, and 45 (73.8%) patients underwent open surgery (P = 0.09). Complications, including catheter obstruction, leak, abdominal hernia, and peritonitis, were not statistically different between the two techniques over 12 months of survival (P > 0.05). Complications among the catheters with less than a year survival, including obstruction, leak, catheter displacement, hernia, and peritonitis, were not significantly different comparing open surgery with laparoscopic technique (P > 0.05).

Conclusion:

Considering complications, PD catheter implantation through laparoscopic surgery was not statistically different from open surgery, neither for those with less than 12 months of survival nor for those with over a year.

KEYWORDS:

Catheter obstruction; hernia; laparoscopic technique; peritoneal catheter; peritoneal dialysis; peritonitis

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