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Kidney Week

Abstract: SA-PO646

Surgical Outcomes Associated with Simple vs. Complex Peritoneal Dialysis Catheter Placement

Session Information

  • Home Dialysis - II
    November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Shah, Ankur, Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
  • Hu, Susie L., Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
  • Raker, Christina A., Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
Background

Patients receiving peritoneal dialysis are dependent upon stable, reliable access to their peritoneal cavity via a surgical or percutaneously placed catheter. Advanced laparoscopic catheter placement has been demonstrated to have better catheter related outcomes compared to simple placement. In this study, we report baseline characteristics and 30 day surgical outcomes of simple versus complex laparoscopic PD catheter placement in a national US based cohort.

Methods

We conducted a retrospective analysis using the NSQIP database from January 1, 2013, to December 31, 2018. Patients who underwent peritoneal dialysis catheter placement were identified using relevant Current Procedural Terminology (CPT) codes. Simple catheter insertion was defined as the absence of additional procedures while complex was defined as catheter extension or omentopexy. Data on patient characteristics, surgical approach (simple or complex), and postoperative outcomes were extracted. The primary outcomes of interest included death, length of stay, and surgical site infection.

Results

A total of 9,593 patients who underwent laparoscopic peritoneal dialysis catheter placement were included in the analysis. Of these 89.95% received simple catheter placement, while 10.05% underwent advanced techniques. Patients who underwent complex catheter placement had no difference in mortality (adjusted odds ratio (aOR) 0.54, 95% Confidence Interval (CI) 0.19 – 1.52, p = 0.25), surgical site infection (OR 0.59, 95% CI 0.34 – 1.03, p = 0.06), or prolonged length of stay (>7 days) (OR 0.95, 95% CI 0.51 – 1.78, p = 0.87) compared to patients receiving simple catheter placement.

Conclusion

This study demonstrates that advanced peritoneal dialysis catheter placement techniques are associated with similar surgical outcomes compared to simple techniques. It is already known that patients receiving advanced catheter placement have lower rates of catheter tip migration, flow obstruction, and better long term catheter survival. These findings suggest that the adoption of advanced techniques may lead to improved long-term catheter related outcomes without sacrificing short term surgical outcomes.

Funding

  • Clinical Revenue Support