This booklet has information you need to know to help you care for a Tenckhoff catheter at home. You can use it to learn more about: • Pleural effusion and. Over a period of 33 months a total of 2, peritoneal dialyses were carried out by means of indwelling Tenckhoff catheters in 65 patients suffering from terminal .
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The Journal publishes articles on basic or clinical research relating to nephrology, arterial hypertension, dialysis and kidney transplants.
It is governed by the peer review system and all original papers are subject to internal assessment and external reviews. The journal accepts submissions of articles in English and in Spanish languages. The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during tenckhpff two receding years. CiteScore measures average citations received per document published.
SRJ is a prestige metric based on the idea that not all citations are tenchoff same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal’s impact.
SNIP measures contextual citation impact by wighting ce based on the total number of citations in a subject field. Median follow-up was 25 months. Catheter outflow failure rate was 7. El seguimiento medio ha sido de 25 meses. Media de tiempo al alta: Peritoneal dialysis PD is a valid alternative to haemodialysis, which, in comparison, possesses some advantages.
With regards to patients, PD allows for improved mobility, more dietary freedom, tencmhoff haemodynamic control and less technical complexity. In sum, PD patients have higher satisfaction than patients on haemodialysis. Catheter placement techniques have evolved from open surgery to minimally invasive procedures over the past two decades. In parallel, percutaneous placement of the dialysis catheters through the Seldinger technique has been used. Open surgery is a simple procedure, which requires a minimal laparotomy, and has been the most widely used option.
These technical problems with open surgery led to the development of new strategies for PD catheter placement two decades ago. Laparoscopic surgery, performed mostly with three trocars, was developed at this point. Less postoperative pain allows for an earlier discharge and cxteter early normalisation of social life.
In this study we describe a new surgical technique for PD catheter placement using yenckhoff laparoscopic approach with two ports. This initial experience examines viability, effectiveness, and safety.
We prospectively analysed 51 consecutive patients who underwent PD catheter placement at our centre from January to July Demographic, clinical, preoperative and postoperative data were collected prospectively. All procedures were performed under general anaesthesia. The tenckhooff body mass index was Here we describe a new surgical technique using two 12mm ports for PD catheter placement; for this, tenkchoff Guyon guide with atraumatic tip was used Figure 1.
After lubricating the Guyon guide, the catheter was placed over it to obtain a rigidly braced catheter. An Oreopoulos-Zellerman catheter was used. We achieved pneumoperitoneum by minimal periumbilical laparotomy and a 12mm trocar was placed. Under direct visualisation, a left pararectus 12mm trocar was placed. The cateer were placed through this trocar and the catheter with catetr guide was placed through the periumbilical trocar. Then, the tip of the catheter was situated in the pouch of Douglas and the Guyon guide was removed.
Proper catheter position was checked visually, after which the two trocars could be removed. A subcutaneous tunnel was created between the two trocars and the catheter is exteriorised through the left pararectus trocar hole Figure 2.
All procedures were completed laparoscopically with two 12mm ports. Mean operative time was 32 minutes range: One patient tenckhogf catheter obstruction in the first 24 hours after placement and required surgical revision and relocation. No other complications occurred during the intraoperative or immediate postoperative period. The average stay was 1. Patients who remained in the hospital after 24 hours of the procedure did so for medical problems unrelated to the procedure.
There were no cuff extrusions or eventrations. The catheter obstruction rate was 7. One of these patients required catheter removal due to severe peritonitis. In the other case, the catheter did not result in obstruction or peritonitis, and worked correctly. A total of three patients died, an average of 16 months after catheter placement 2.
The causes of death were cardiovascular complications secondary to end-stage renal disease. Mortality was not related to PD or to the catheter. The survival curves of patients on PD are shown in Figure 3, and the survival curve of catter catheters in Figure 4. A total of three catheters 5. According to our experience, we had 0. Two catheters were removed because of technical complications in the postoperative period. In the first case, the patient developed abdominal pain that required exploratory laparotomy and it tencknoff that the catheter was lying in a loop of intestine.
After verifying that the bowel loop was viable, the catheter was removed and a new one placed. The patient is currently in the PD program. The second patient, nine months after surgery, presented with canalisation of a peritoneum-vaginal tract and developed a hydrocele.
The patient refused surgical correction and was transferred to the haemodialysis programme.
Use of Tenckhoff Catheter for Peritoneal Dialysis in Terminal Renal Failure
PD is a safe and effective option for patients with end-stage renal caateter. Furthermore, there is evidence of better preservation of residual renal function when compared with haemodialysis.
Our technique, described above, is a simple procedure through two 12mm trocars. Furthermore, it is a very fast procedure, with a short operative time. Regarding the intraoperative advantages, laparoscopy allows tenvkhoff optimal visualisation and evaluation of the peritoneal cavity, allowing precise catheter placement. Furthermore, laparoscopy allows for release of peritoneal adhesions if necessary.
The use of a Guyon guide has been very helpful for accurate placement of the catheter, as the atraumatic tip and rigidity make it cateer to both guide the catheter to the pouch of Douglas and reposition it if necessary.
Based on our experience, the obstruction rate was 3.
Peritoneal Dialysis Catheters | Medtronic
Despite this low rate, we must bear in mind our limited follow-up. Peritoneal leakage tenckhoft range from caetter. In our experience, we have not had any leakage. This complication is not only associated with open surgery, but also with the laparoscopic approach. Paramedial placement and the creation of a long subcutaneous tunnel are strategies for attempting to reduce this complication 32,33 and may explain the absence of fistula in our series.
In analysing our technique compared to other three-port laparoscopic techniques, our experience is comparable in terms of surgical time, hospitalisation time, and catheter obstruction rate. Accepting our limited follow-up, our results are at least equal. We did not have peritonitis in the early postoperative period first two weeks after implantation of the catheter but we did have one episode of peritonitis per patient every In short, we believe that our technique is a simple and rapid procedure with few complications and short hospitalisation time, due to its reliability and excellent results in terms of catheter function.
Oreopoulos-Zellerman catheter with Guyon guide with atraumatic tip. Periumbilical 12mm port for the catheter and left pararectus port with 12mm optics. KM curve showing the survival of peritoneal dialysis patients.
Catheters removed or replaced due to technical problems obstruction, peritonitis or tehckhoff. Patients excluded from the CAPD programme. Cause of exclusion, time since start, current treatment, and catheter status at time of exclusion. Home Articles in press Archive. Previous article Next article.
May Pages Laparoscopic placement of peritoneal dialysis catheter: Vera-Rivera bJ. Corral Moro aJ. This item has received. Show more Show less. An Oreopoulos-Zellerman catheter was used. Patients who remained in the hospital after 24 hours of the procedure did so for medical problems unrelated to the procedure.
Peritoneal Dialysis Catheters
tenckboff In the other case, the catheter did not result in obstruction or peritonitis, and worked correctly. Furthermore, laparoscopy allows for release of peritoneal adhesions if necessary.
Paramedial placement and the creation of a long subcutaneous tunnel are strategies for attempting to reduce this complication 32,33 and may explain the absence of fistula in our series. Principles, uses, and complications of hemodialysis. Med Clin North Am ; Surgical aspects of the Tenckhoff peritoneal dialysis catheter. A 7 year experience.
Am J Surg ;