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输尿管镜辅助下使用 16Fr 可剥鞘行腹膜透析置管术:47 例患者 3 年结果。

The ureteroscope-assisted "Mini-Perc" technique of placement of peritoneal dialysis catheters with a 16-Fr Peel-Away sheath: 3-year results in 47 patients.

机构信息

Department of Nephrology, Affiliated Drum Tower Hospital of Nanjing University, Nanjing, Jiangsu, People's Republic of China.

出版信息

Int Urol Nephrol. 2013 Feb;45(1):233-7. doi: 10.1007/s11255-012-0229-6. Epub 2012 Jul 22.

Abstract

OBJECTIVES

This study was undertaken to evaluate the clinical feasibility, safety and effect of the ureteroscope-assisted "Mini-Perc" technique with a 16-Fr Peel-Away sheath for insertion of peritoneal dialysis catheters in end-stage renal disease (ESRD) patients.

PATIENTS AND METHODS

47 consecutive ESRD patients underwent ureteroscope-assisted placement of peritoneal dialysis catheters via a 16-Fr Peel-Away sheath. Informed consent form was signed by patients under principle of voluntary.

RESULTS

The mean duration of the operation was 40 min (range, 21-75 min). Seven patients (14.9 %) experienced mechanical complications: catheter tip migration in 1 patient (2.1 %), slightly bloody ascites in 4 patients (8.5 %) and catheter-related peritonitis in 2 patients (4.3 %). Two catheters (4.3 %) were removed after renal transplantation. One patient (2.1 %) died from heart failure. One catheter (2.1 %) was explanted because of malfunction. After a mean follow-up time of 15 months (range, 2-36 months), 42 catheters are still functioning properly.

CONCLUSIONS

The ureteroscope-assisted "Mini-Perc" technique with a 16-Fr Peel-Away sheath is a simple, safe and effective method for placement of peritoneal dialysis catheters in ESRD patients.

摘要

目的

本研究旨在评估在终末期肾病(ESRD)患者中使用输尿管镜辅助的 16Fr Peel-Away 鞘进行“Mini-Perc”技术插入腹膜透析导管的临床可行性、安全性和效果。

患者和方法

47 例 ESRD 患者通过 16Fr Peel-Away 鞘接受了输尿管镜辅助下的腹膜透析导管置管术。患者在自愿原则下签署了知情同意书。

结果

手术平均持续时间为 40 分钟(范围 21-75 分钟)。7 名患者(14.9%)出现机械并发症:1 名患者(2.1%)导管尖端迁移,4 名患者(8.5%)出现少量血性腹水,2 名患者(4.3%)发生导管相关性腹膜炎。2 根导管(4.3%)在肾移植后被移除。1 名患者(2.1%)因心力衰竭死亡。1 根导管(2.1%)因故障被取出。在平均 15 个月(范围 2-36 个月)的随访后,42 根导管仍正常工作。

结论

输尿管镜辅助的 16Fr Peel-Away 鞘“Mini-Perc”技术是一种简单、安全、有效的方法,可用于 ESRD 患者的腹膜透析导管置管术。

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