Harissis Haralampos V, Katsios Christos S, Koliousi Elli L, Ikonomou Margarita G, Siamopoulos Konstantinos C, Fatouros Michalis, Kappas Angelos M
Department of Surgery, University Hospital of Ioannina, Panepistimiou Av., Ioannina 45500, Greece.
Am J Surg. 2006 Jul;192(1):125-9. doi: 10.1016/j.amjsurg.2006.01.033.
Various laparoscopic techniques have been described for the insertion of peritoneal dialysis catheters. However, most use 3 to 4 ports, thus multiplying the potential risk for abdominal wall complications (hemorrhage, hernia, leaking).
A Tenckhoff catheter was placed laparoscopically, using just 1 port, in 13 consecutive patients with end-stage renal failure. All catheters were fixed in the abdominal cavity with no additional ports for this purpose.
After a follow-up of 76 patient-months, all catheters are working properly. There were no postoperative wall hemorrhages, early leaking, or hernias. There was 1 case of catheter migration and 2 cases of late leaking in 2 patients in total, due to severe constipation. There were no exit site or tunnel infections. One episode of peritonitis was successfully treated with antibiotics.
The simplicity and the rapidity of the method justifies serious consideration for its use as the standard Tenckhoff catheter placement.
已有多种腹腔镜技术用于腹膜透析导管的置入。然而，大多数技术需要3至4个穿刺孔，从而增加了腹壁并发症（出血、疝、渗漏）的潜在风险。
对13例终末期肾衰竭患者采用仅1个穿刺孔的腹腔镜技术置入Tenckhoff导管。所有导管均在腹腔内固定，未为此目的额外使用穿刺孔。
经过76个患者月的随访，所有导管均正常工作。无术后腹壁出血、早期渗漏或疝发生。共有2例患者出现1例导管移位和2例因严重便秘导致的晚期渗漏。无出口部位或隧道感染。1例腹膜炎经抗生素治疗成功。
该方法的简单性和快速性使其有理由被认真考虑作为标准的Tenckhoff导管置入方法。
