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Outcomes of peritoneal dialysis catheter placement in vascular surgery practice; time to shift the catheter paradigm
Abindra Sigdel, MD, Houssam K. Younes, MD, Charudatta S. Bavare, MD, Mitul S. Patel, MD, Hosam F. El-Sayed, MD, Eric K. Peden, MD, Alan B. Lumsden, MD, Mark G. Davies, MD.
Methodist DeBakey Heart & Vascular Center, Houston, TX, USA.
OBJECTIVES:
To look at the outcomes of peritoneal dialysis catheters placed by vascular surgeons at a major referral center.
METHODS:
A retrospective chart review of all the patients that underwent peritoneal dialysis catheter placement between January 2009 and January 2012 was performed. Operative reports, admission and follow up records were reviewed to determine the outcome of the catheter.
RESULTS:
Forty three peritoneal dialysis catheters were placed in 40 patients during a 3 year period. Twenty four (56%) catheters were placed via open laparotomy and the rest were placed laparoscopically. Twenty two catheters (51%) required laparoscopic revisions in order to maintain adequate functionality. Of the 18 catheters that were removed during this period, 4 (9%) had infection, 7(16%) had nonfunction or malfunction and 6 (14%) were removed because the patients had received successful renal transplant. There were 7% perioperative morbidity and no perioperative mortality. Freedom from reintervention was 49% and 34% at one and two years respectively. Cumulative patency and catheter functionality were 67% and 56%; and 66% and 55% at one and two years respectively. There was one long term event, a port site hernia that required operative intervention. There was no difference in outcomes for either open or laparoscopically assisted placements.
CONCLUSIONS:
Peritoneal dialysis catheter placement through open or laparoscopic means by vascular surgeons is safe and effective and leads to excellent long term dialysis access. Peritoneal dialysis should not be ignored as a viable dialysis paradigm.
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