Kidney Disease Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
BMC Nephrol. 2012 Jul 27;13:69. doi: 10.1186/1471-2369-13-69.
Peritoneal dialysis has been proven to be a safe and effective mode of renal replacement therapy for patients with end-stage renal disease. The usage of laparoscopic catheter placement technique was increased in recent years. But the advantages and disadvantages between the laparoscopic catheter placement technique and open laparotomy technique were still http://in controversy. The objective of this study is to access the operation-related data and complications of catheter placement for peritoneal dialysis (PD) patients, Then to determine the better method for catheter insertion.
We performed a systematic review and meta-analysis on published studies identified by the databases PubMed, EMBASE, Highwire, and the Cochrane Library. Analysis was performed using the statistical software Review Manager Version 5.0.
We assessed the operation-related data and complications of four randomized controlled trials (RCTs) and ten observational studies. The available data showed that laparoscope prolonged the time for catheter insertion in PD patients, however, the two groups did not significantly differ in hospital stays, early and late complications, including infection, dialysate leaks, catheter migration, pericannular bleeding, blockage and hernia.
The data showed that Laparoscopic catheter placement had no superiority to open surgery. However, this treatment still needs to be confirmed in a large, multi-center, well-designed RCT.
腹膜透析已被证明是终末期肾病患者安全有效的肾脏替代治疗方式。近年来，腹腔镜下置管技术的应用有所增加。但是腹腔镜置管技术与剖腹手术之间的优缺点仍存在争议。本研究旨在评估腹膜透析（PD）患者导管置管的手术相关数据和并发症，以确定更好的置管方法。
我们通过数据库 PubMed、EMBASE、Highwire 和 Cochrane Library 对已发表的研究进行了系统评价和荟萃分析。使用统计软件 Review Manager Version 5.0 进行分析。
我们评估了四项随机对照试验（RCT）和十项观察性研究的手术相关数据和并发症。现有数据表明，腹腔镜下置管会延长 PD 患者的置管时间，但两组患者的住院时间、早期和晚期并发症（包括感染、透析液渗漏、导管移位、套囊周围出血、阻塞和疝）无显著差异。
数据显示腹腔镜下置管与剖腹手术相比没有优势。然而，这种治疗方法仍需要在大型、多中心、精心设计的 RCT 中得到进一步证实。
