Abstract: FR-PO681
Comparison of Different Techniques for Peritoneal Dialysis Catheter Insertion: A Systematic Review and Network Meta-Analysis
Session Information
- Dialysis: Peritoneal Dialysis - II
October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 703 Dialysis: Peritoneal Dialysis
Author
- Yang, Lichuan, West China Hospital of Sichuan University, Chengdu city, China
Background
<!--StartFragment--><!--StartFragment-->Peritoneal dialysis (PD) is one of the important treatment methods of end-stage renal disease (ESRD). Various techniques had been applied to the PD catheter insertion, including open surgery, laparoscopy and percutaneous techniques. However, the best technique, regarding both the catheter survival and catheter related complications, is still controversial. Previous studies did not compare the three techniques at the same time. Therefore, we did a systematic review and network meta-analysis to identify the best insertion method.
Methods
<!--StartFragment--><!--StartFragment--><!--StartFragment-->We systematically searched PubMed, Embase, Cochrane library, CNKI, WanFang and VIP database for randomized controlled trial, case-control study and cohort study until December 2017. Quality assessment and data extraction were conducted by two reviewers independently. We performed a direct meta-analysis and Bayesian network meta-analysis to pooled odds ratios (OR) or weighted mean differences (WMD) with 95% credible intervals (CrI) with random effects model. The node-splitting method was used to assess the inconsistency. We estimated the potential ranking probability of treatments by calculating the surface under the cumulative ranking curve for each intervention. Meta data is analysed by Addis software version 1.16.5.
Results
<!--StartFragment--><!--StartFragment-->Forty studies involving 6494 patients were included (10 RCTs and 30 retrospective studies). <!--StartFragment-->The surface under the cumulative ranking curve (SUCRA) ranking from the network analysis showed that laparoscopy had the lowest occurrence of PD catheter displacement and obstruction , followed by percutaneous insertion and open surgery. Percutaneous insertion had the lowest occurrence of hernia, exit-site and tunnel infections. Open surgery had the lowest incident of bleeding.
Conclusion
<!--StartFragment-->Considering about the dysfunction of PD catheter, laparoscopy may be the best technique for PD catheter insertion. Different technique has the advantage of their own and more RCTs with larger sample size, comparing laparoscopy and percutaneous insertion directly are needed in the further.