AIM: Blind peritoneal dialysis (PD) catheter instrumentation with a Tenckhoff trocar is performed without direct visualization of the peritoneum. This method requires the least equipment, it is safe and it can be performed mainly by nephrologists. We report here on our long-term experience with this method as performed by nephrologists. METHODS: We reviewed the medical records at Yeungnam University Hospital in Korea and identified all the patients who had undergone blind PD catheter instrumentation with a Tenckhoff trocar by nephrologists. Four hundred and three patients were enrolled. RESULTS: Early complications occurred in 7.7% (four patients with pericatheter bleeding, one patient with pleural leakage, two patients with migration, two patients with omental wrapping, three patients with exit site/tunnel infection and 19 patients with peritonitis). The late mechanical complications included eight cases of hernia, three cases of catheter extrusion, five cases of leakage, four cases of migration and five cases of omental wrapping. Exit site/tunnel infection and peritonitis occurred at a rate of 0.067 and 0.40 episodes/year, respectively. The intervention free survival rate was 84.5% at one year and 63.3% at 5 years. The catheter survival rate was 96.5% at one year and 83.6% at 5 years. CONCLUSION: This study provides evidence that blind PD catheter placement with a Tenckhoff trocar requires the least equipments, and it is easy to perform. Therefore, if the general anesthesia is impossible or equipment, such as fluoroscopy and laparoscopy, were not available, this method may be an alternative choice for PD catheter placement.
AIM: Blind peritoneal dialysis (PD) catheter instrumentation with a Tenckhoff trocar is performed without direct visualization of the peritoneum. This method requires the least equipment, it is safe and it can be performed mainly by nephrologists. We report here on our long-term experience with this method as performed by nephrologists. METHODS: We reviewed the medical records at Yeungnam University Hospital in Korea and identified all the patients who had undergone blind PD catheter instrumentation with a Tenckhoff trocar by nephrologists. Four hundred and three patients were enrolled. RESULTS: Early complications occurred in 7.7% (four patients with pericatheter bleeding, one patient with pleural leakage, two patients with migration, two patients with omental wrapping, three patients with exit site/tunnel infection and 19 patients with peritonitis). The late mechanical complications included eight cases of hernia, three cases of catheter extrusion, five cases of leakage, four cases of migration and five cases of omental wrapping. Exit site/tunnel infection and peritonitis occurred at a rate of 0.067 and 0.40 episodes/year, respectively. The intervention free survival rate was 84.5% at one year and 63.3% at 5 years. The catheter survival rate was 96.5% at one year and 83.6% at 5 years. CONCLUSION: This study provides evidence that blind PD catheter placement with a Tenckhoff trocar requires the least equipments, and it is easy to perform. Therefore, if the general anesthesia is impossible or equipment, such as fluoroscopy and laparoscopy, were not available, this method may be an alternative choice for PD catheter placement.
Authors: Mehmet Emin Gunes; Gungor Uzum; Oguz Koc; Yiğit Duzkoylu; Meltem Kucukyilmaz; Yavuz Selim Sari; Vahit Tunalı; Sennur Kose Journal: ISRN Surg Date: 2013-05-15