John H Crabtree1, Raoul J Burchette. 1. Department of Surgery, Southern California Permanente Medical Group, Kaiser Permanente Bellflower Medical Center, Bellflower, CA 90706, USA. John.H.Crabtree@kp.org
Abstract
BACKGROUND: Chronic exit-site and tunnel infections of the peritoneal dialysis catheter are significant causes of catheter loss. Surgical salvage procedures that can effectively resolve the infection and preserve dialysis are of major importance. METHODS: Thirteen patients with chronic exit-site and tunnel infections underwent surgical salvage consisting of unroofing the tunnel tract and shaving of the superficial catheter cuff. A control group of 138 patients implanted during the same time span as the study group was used for infection rate and survival comparisons. RESULTS: The salvage procedure cured the infection in all patients. No dialysate leaks occurred. Peritoneal dialysis was not interrupted. Surgical salvage provided successful long-term peritoneal dialysis that was equivalent to the cohort dialysis population. CONCLUSION: Surgical salvage by unroofing/cuff shaving is an effective long-term solution for chronic exit-site and tunnel infection.
BACKGROUND: Chronic exit-site and tunnel infections of the peritoneal dialysis catheter are significant causes of catheter loss. Surgical salvage procedures that can effectively resolve the infection and preserve dialysis are of major importance. METHODS: Thirteen patients with chronic exit-site and tunnel infections underwent surgical salvage consisting of unroofing the tunnel tract and shaving of the superficial catheter cuff. A control group of 138 patients implanted during the same time span as the study group was used for infection rate and survival comparisons. RESULTS: The salvage procedure cured the infection in all patients. No dialysate leaks occurred. Peritoneal dialysis was not interrupted. Surgical salvage provided successful long-term peritoneal dialysis that was equivalent to the cohort dialysis population. CONCLUSION: Surgical salvage by unroofing/cuff shaving is an effective long-term solution for chronic exit-site and tunnel infection.
Authors: Stephen Haggerty; Scott Roth; Danielle Walsh; Dimitrios Stefanidis; Raymond Price; Robert D Fanelli; Todd Penner; William Richardson Journal: Surg Endosc Date: 2014-10-08 Impact factor: 4.584