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Abstract: TH-PO867

The Lower Left Quadrant Incision Significantly Reduced Catheter Tip Migration in Peritoneal Dialysis – A Single Center Retrospective Analysis

Session Information

  • Peritoneal Dialysis - I
    November 02, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

  • 608 Peritoneal Dialysis

Authors

  • Chen, Yaohui, Jiangxi Provincial People's Hospital, Nanchang, China
  • Yang, Lin, Jiangxi Provincial People's Hospital, Nanchang, China
  • Lang, Chunyan, Jiangxi Provincial People's Hospital, Nanchang, China
  • Yang, Lili, Jiangxi Provincial People's Hospital, Nanchang, China
  • Liu, Zhenhua, Jiangxi Provincial People's Hospital, Nanchang, China
  • Li, Yun, Jiangxi Provincial People's Hospital, Nanchang, China
Background

The reported rate of catheter tip migration in peritoneal dialysis(PD) is 5-35%. In order to reduce it, a modified catheter implantation incision was studied.

Methods

One hundred and seventy-six of Han Chinese end stage renal disease(ESRD) patients were implanted with Tenckhoff double cuff straight catheter to carry out PD from November 2010 to September 2016. The patients were divided into two groups, 40 in the conventional group and 136 in the modified group. In the conventional group, the incision for the catheter implantation was at 9-13cm above pubic symphysis, left or right paramedian. In the modified group, the incision was at 6-9cm above pubic symphysis and about 2cm left paramedian in the lower left quadrant. It was also the position for catheter pouch. All operations were performed by one physician. The dialysate inflow and outflow times, ultrafiltration volume, urine volume, body weight and edema changes, leakage, infection, bleeding, intestinal obstruction, and catheter tip migration were observed.

Results

Within six months of implantation, 6(15%) patients in the conventional group vs 4(2.94%) patients in the modified group had catheter tip migration. Compared with the conventional group, the incidence of catheter tip migration was significantly lower in the modified group (p=0.01). In addition, in the conventional group, all 6 patients who had catheter tip migration needed surgical repositioning after conservative treatment to restore the catheter function. In the modified group, non-surgical repositioning in 1 of the 4 patients with catheter tip migration was achieved while the rest needed surgical repositioning. There were no significant differences in the dialysate inflow and outflow times, ultrafiltration volume, urine volume, body weight between two groups. There were no obvious leakage, infection, bleeding, intestinal obstruction and other complications.

Conclusion

The modified incision at 6-9cm above pubic symphysis and about 2cm left paramedian in lower left quadrant significantly reduced catheter tip migration in peritoneal dialysis in Han Chinese.