Crabtree John H, Burchette Raoul J
Department of Surgery, Southern California Permanente Medical Group, Kaiser Permanente Bellflower Medical Center, Bellflower, CA 90706, USA.
Am J Surg. 2005 Jul;190(1):4-8. doi: 10.1016/j.amjsurg.2005.04.010.
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.
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.
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.
Surgical salvage by unroofing/cuff shaving is an effective long-term solution for chronic exit-site and tunnel infection.
腹膜透析导管的慢性出口处及隧道感染是导致导管丢失的重要原因。能够有效解决感染并保留透析功能的外科挽救手术至关重要。
13例慢性出口处及隧道感染患者接受了包括打开隧道通路和剃除浅表导管套囊在内的外科挽救手术。选取与研究组在同一时间段植入导管的138例患者作为对照组，用于比较感染率和生存率。
挽救手术治愈了所有患者的感染。未发生透析液渗漏。腹膜透析未中断。外科挽救手术实现了成功的长期腹膜透析，与队列透析人群相当。
通过打开隧道/剃除套囊进行的外科挽救手术是治疗慢性出口处及隧道感染的一种有效的长期解决方案。
