| ORIGINAL ARTICLE |
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| Year : 2023 | Volume
: 39
| Issue : 1 | Page : 46-52 |
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Continuous ambulatory peritoneal dialysis catheter insertion by open technique: 20-year experience from a single center
Mrinal Pahwa, Mahendra Singh, Vipin Tyagi, Manu Gupta, Saurabh Jain, Sudhir Chaddha, Harsha Jauhari
Department of Urology, Sir Ganga Ram Hospital, Delhi, 1Department of Urology, AIIMS, Jodhpur, India
Correspondence Address:
Mahendra Singh
Department of Urology, Sir Ganga Ram Hospital, Delhi, 1Department of Urology, AIIMS, Jodhpur
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/iju.iju_156_22
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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. |
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