Experiences on bedside Tenckhoff catheter implantation.

OBJECTIVE

To clarify the outcome of a bedside technique of peritoneal dialysis (PD) catheter implantation which is practiced differently from worldwide guidelines in some points.

MATERIAL AND METHOD

This retrospective study was conducted in end stage renal diseases (ESRD) patients treated with chronic ambulatory peritoneal dialysis (CAPD). Catheter placement was initiated by the authors' bedside technique comprising no antibiotic prophylaxis, dry abdomen, and routinely right sided exit site as our protocol. All events within one month postimplantation, such as tip mal-position, malfunction, infection, and bleeding were analyzed.

RESULTS

One hundred and fourteen cases were participated with age, ranged from 14 to 78 yrs. Of the participating subjects, 38.5% was female and 60.52% was diabetes mellitus (DM). After 1 month, 113 out of 114 cases (99.1 %) accomplished CAPD. Of these, 79.8 % had good tip position and function after the break-in period. Early mal-position and poor flow was detected in 21 cases (18.4 %); 9 of them responded to laxative bowel stimulation while 12 cases needed surgical correction. Exit-site infection and/or wound infection were found in 7.9%. The peritonitis rate was 2.63%. All cases with infection were cured. Coagulase positive Staphylococcus aureus was the major causative organism.

CONCLUSION

Bedside Tenckhoff catheter implantation without antibiotic prophylaxis in dry abdomen is a safe modality for selected ESRD patients.