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Abstract: FR-PO528

Comparison of Outcomes Between Percutaneous and Surgical Placement of Peritoneal Catheters in Dialysis Patients: A Meta-Analysis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Huang, Linxi, Division of Nephrology, Kidney Institute of CPLA, Changzheng Hospital, Second Military Medical University, Shanghai, China
  • Xue, Cheng, Shanghai Changzheng Hospital, Shanghai, China
  • Xu, Jing, Shanghai Changzheng Hospital, Shanghai, China
  • Mao, Zhiguo, Changzheng Hospital, Shanghai, SHANGHAI, China
Background

The successful insertion of the peritoneal dialysis catheter (PDC) ensures effective catheter function and technique survival. The most commonly used technique is the surgical approach by laparotomy or laparoscopy. Minimally invasive techniques are currently developing and seem to be an alternative. We evaluated the efficacy and safety of the percutaneous insertion methods compared to conventional surgical methods.

Methods

Studies comparing percutaneous and surgical methods of PDC insertion were identified through databases of PubMed, EMBASE, Cochrane and Web of Science. Catheter survival, dialysate fluid leakage, mechanical and infectious complications were analyzed using random effects model and results were presented as odds ratio (OR) and 95% confidence intervals (CIs).

Results

Sixteen studies were finally identified. The pooled data demonstrated no differences in catheter survival, dialysate fluid leakage and mechanical complications between percutaneous and surgical way (OR = 1.24, 95% CI = 0.81–1.91, P= 0.33; OR =1.49, 95% CI = 0.98–2.26, P= 0.06; OR = 0.65, 95% CI = 0.39–1.08, P= 0.08, respectively). Infectious complications occurred less in percutaneous group (OR = 0.56, 95% CI = 0.32–0.96, P= 0.04). The malposition incidence was obviously lower in percutaneous method compared with surgical method (OR = 0.51, 95% CI = 0.32–0.82, P= 0.005). The detailed analysis on bleeding, omental wrapping, hernia, exit site infection, peritonitis and tunnel infection did not show difference.

Conclusion

The percutaneous method is a safe and effective alternative to insert peritoneal catheters and could be an optimal choice besides the conventional surgical way.

Funding

  • Government Support - Non-U.S.