Bunker Daniel, Ilie Victor, Fisher Dean
Surgery Department, Dubbo Base Hospital, Dubbo, New South Wales, Australia.
ANZ J Surg. 2014 Jan-Feb;84(1-2):73-7. doi: 10.1111/j.1445-2197.2012.06273.x. Epub 2012 Sep 17.
Peritoneal dialysis via Tenckhoff catheter predisposes to hernia formation due to both local and systemic factors. Another important complication of peritoneal catheter insertion includes infection, which can prompt removal of the catheter.
We performed a retrospective study between January 2005 and July 2011 of 61 patients who underwent laparoscopic placement of a Tenckhoff catheter and peritoneal dialysis at our institution using a single-port technique. We analysed complications of Tenckhoff insertion, specifically infection and the formation of hernias requiring operative management.
Infections noted in our patients included peritonitis (10%) and exit-site infection (5%). Of the five patients who required re-insertion of Tenckhoff catheter, four were for infective complications. A total of seven hernias developed in five (8%) of patients, mostly inguinal or umbilical near the Hassan port entry site.
With infection and hernia formation being the main contributors to failure of the procedure, actively addressing the entry site and areas predisposed to hernia formation, observing aseptic technique and meticulous attention to early signs of complications during follow-up are vital to improve success rates. The outcomes of the laparoscopic single-port insertion technique shows promise compared with conventional Tenckhoff catheter insertion techniques.
由于局部和全身因素，经Tenckhoff导管进行腹膜透析易导致疝形成。腹膜导管插入的另一个重要并发症是感染，这可能促使导管拔除。
我们对2005年1月至2011年7月期间在我院采用单孔技术进行Tenckhoff导管腹腔镜置入及腹膜透析的61例患者进行了回顾性研究。我们分析了Tenckhoff导管插入的并发症，特别是感染以及需要手术处理的疝的形成。
我们的患者中发现的感染包括腹膜炎（10%）和出口部位感染（5%）。在需要重新插入Tenckhoff导管的5例患者中，4例是由于感染性并发症。共有7例疝在5例（8%）患者中发生，大多为靠近Hassan端口进入部位的腹股沟疝或脐疝。
由于感染和疝形成是该手术失败的主要原因，积极处理进入部位和易发生疝形成的区域、遵守无菌技术以及在随访期间密切关注并发症的早期迹象对于提高成功率至关重要。与传统的Tenckhoff导管插入技术相比，腹腔镜单孔插入技术的结果显示出前景。
