Outcomes after peritoneal dialysis catheter placement

J Pediatr Surg. 2016 May;51(5):730-3. doi: 10.1016/j.jpedsurg.2016.02.011. Epub 2016 Feb 11.

Abstract

Background: The purpose of this study was to review surgical outcomes after elective placement of peritoneal dialysis (PD) catheters in children with end-stage renal disease.

Methods: Children with PD catheters placed between February 2002 and July 2014 were retrospectively reviewed. Outcomes were catheter life, late (>30days post-op) complications (catheter malfunction, catheter malposition, infection), and re-operation rates. Comparison groups included laparoscopic versus open placement, age<2, and weight<10kg. Univariate and multivariate analysis were performed.

Results: One hundred sixteen patients had 173 catheters placed (122 open, 51 laparoscopic) with an average patient age of 9.7±6.3years. Mean catheter life was similar in the laparoscopic and open groups (581±539days versus 574±487days, p=0.938). The late complication rate was higher for open procedures (57% versus 37%, p=0.013). Children age<2 or weight<10kg had higher re-operation rates (64% versus 42%, p=0.014 and 73% versus 40%, p=0.001, respectively). Adjusted for age and weight, open technique remained a risk factor for late complications (OR 2.44, 95% CI 1.20-4.95) but not re-operation.

Discussion: Laparoscopic placement appears to reduce the rate of late complications in children who require PD dialysis catheters. Children <2years age or <10kg remain at risk for complications regardless of technique.

Keywords: Chronic kidney disease; Dialysis; Peritoneal.

MeSH terms

  • Adolescent
  • Age Factors
  • Analysis of Variance
  • Body Weight
  • Catheterization / adverse effects
  • Catheterization / methods*
  • Catheters, Indwelling* / adverse effects
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Kidney Failure, Chronic / surgery*
  • Laparoscopy / methods
  • Male
  • Peritoneal Dialysis / instrumentation*
  • Peritoneum / surgery*
  • Postoperative Complications
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Young Adult