Jennifer L Carpenter1, Sara C Fallon1, Sarah J Swartz2, Paul K Minifee1, Darrell L Cass1, Jed G Nuchtern1, Ashwin P Pimpalwar1, Mary L Brandt3. 1. Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX. 2. Renal Service, Department of Pediatric Medicine, Texas Children's Hospital, Houston, TX. 3. Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX. Electronic address: mary.brandt@bcm.edu.
Abstract
BACKGROUND: The purpose of this study was to review surgical outcomes after elective placement of peritoneal dialysis (PD) catheters in children with end-stage renal disease. METHODS: Children with PD catheters placed between February 2002 and July 2014 were retrospectively reviewed. Outcomes were catheter life, late (>30days post-op) complications (catheter malfunction, catheter malposition, infection), and re-operation rates. Comparison groups included laparoscopic versus open placement, age<2, and weight<10kg. Univariate and multivariate analysis were performed. RESULTS: One hundred sixteen patients had 173 catheters placed (122 open, 51 laparoscopic) with an average patient age of 9.7±6.3years. Mean catheter life was similar in the laparoscopic and open groups (581±539days versus 574±487days, p=0.938). The late complication rate was higher for open procedures (57% versus 37%, p=0.013). Children age<2 or weight<10kg had higher re-operation rates (64% versus 42%, p=0.014 and 73% versus 40%, p=0.001, respectively). Adjusted for age and weight, open technique remained a risk factor for late complications (OR 2.44, 95% CI 1.20-4.95) but not re-operation. DISCUSSION: Laparoscopic placement appears to reduce the rate of late complications in children who require PD dialysis catheters. Children <2years age or <10kg remain at risk for complications regardless of technique.
BACKGROUND: The purpose of this study was to review surgical outcomes after elective placement of peritoneal dialysis (PD) catheters in children with end-stage renal disease. METHODS:Children with PD catheters placed between February 2002 and July 2014 were retrospectively reviewed. Outcomes were catheter life, late (>30days post-op) complications (catheter malfunction, catheter malposition, infection), and re-operation rates. Comparison groups included laparoscopic versus open placement, age<2, and weight<10kg. Univariate and multivariate analysis were performed. RESULTS: One hundred sixteen patients had 173 catheters placed (122 open, 51 laparoscopic) with an average patient age of 9.7±6.3years. Mean catheter life was similar in the laparoscopic and open groups (581±539days versus 574±487days, p=0.938). The late complication rate was higher for open procedures (57% versus 37%, p=0.013). Children age<2 or weight<10kg had higher re-operation rates (64% versus 42%, p=0.014 and 73% versus 40%, p=0.001, respectively). Adjusted for age and weight, open technique remained a risk factor for late complications (OR 2.44, 95% CI 1.20-4.95) but not re-operation. DISCUSSION: Laparoscopic placement appears to reduce the rate of late complications in children who require PD dialysis catheters. Children <2years age or <10kg remain at risk for complications regardless of technique.
Authors: Dagmara Borzych-Duzalka; T Fazil Aki; Marta Azocar; Colin White; Elizabeth Harvey; Sevgi Mir; Marta Adragna; Erkin Serdaroglu; Rajiv Sinha; Charlotte Samaille; Juan Jose Vanegas; Jameela Kari; Lorena Barbosa; Arvind Bagga; Monica Galanti; Onder Yavascan; Giovanna Leozappa; Maria Szczepanska; Karel Vondrak; Kei-Chiu Tse; Franz Schaefer; Bradley A Warady Journal: Clin J Am Soc Nephrol Date: 2016-11-29 Impact factor: 8.237
Authors: Melanie B LaPlant; Daniel A Saltzman; Bradley J Segura; Robert D Acton; Brad A Feltis; Donavon J Hess Journal: Pediatr Surg Int Date: 2018-09-10 Impact factor: 1.827
Authors: Peace D Imani; Jennifer L Carpenter; Cynthia S Bell; Mary L Brandt; Michael C Braun; Sarah J Swartz Journal: BMC Nephrol Date: 2018-09-14 Impact factor: 2.388