Al-Dohayan A
Department of Surgery, King Khalid University Hospital, Riyadh, Saudi Arabia.
JSLS. 1999 Oct-Dec;3(4):327-9.
Peritoneal dialysis (PD) remains the generally accepted method for management of renal failure in chronic and acute renal failure. Despite the rapidly increasing use of continuous ambulatory peritoneal dialysis (CAPD) since its introduction, controversy persists as to the efficacy and exact role of the modality in the treatment of end stage renal failure. The aim of this paper is to present the experience with laparoscopic placement of a peritoneal dialysis catheter and starting the peritoneal dialysis on the same day.
The laparoscopic placement of a peritoneal dialysis catheter was performed on 11 patients (10 males and 1 female) with an average age of 35 years, over a 12-month period. The procedure was done using two 5 mm abdominal trocars. The precise position of the catheter on the pelvis was ensured laparoscopically. One to two liters exchange dialysis was used for every patient, and no leakage was recorded.
The patients tolerated the procedure well. The peritoneal dialysis was started immediately. Patients were discharged after an overnight stay, and PD was carried out routinely.
The results of laparoscopic placement of a peritoneal dialysis catheter show the following advantages: minimal incision; less surgical trauma; the procedure hastens the early start of peritoneal dialysis and has no complications.
腹膜透析(PD)仍然是慢性和急性肾衰竭患者普遍接受的肾衰竭治疗方法。尽管自持续非卧床腹膜透析(CAPD)引入以来其使用迅速增加,但关于该模式在终末期肾衰竭治疗中的疗效和确切作用仍存在争议。本文旨在介绍腹腔镜置入腹膜透析导管并在同一天开始腹膜透析的经验。
在12个月期间,对11例患者(10例男性和1例女性)进行了腹腔镜腹膜透析导管置入术,平均年龄35岁。该手术使用两个5毫米的腹部套管针进行。通过腹腔镜确保导管在盆腔的精确位置。每位患者使用1至2升的交换透析液,未记录到渗漏情况。
患者对该手术耐受性良好。腹膜透析立即开始。患者过夜留院观察后出院,并常规进行腹膜透析。
腹腔镜置入腹膜透析导管的结果显示出以下优点:切口最小;手术创伤较小;该手术加速了腹膜透析的早期开始且无并发症。