Division of Pediatric Surgery, David Geffen School of Medicine at UCLA, Box 709818, Los Angeles, CA 90095-7098, USA.
J Pediatr Surg. 2013 Jan;48(1):197-202. doi: 10.1016/j.jpedsurg.2012.10.035.
As peritoneal dialysis (PD) is the preferred long-term dialysis modality in the pediatric population, we sought to identify risk factors for mortality and reoperation.
A retrospective review of patients undergoing PD catheter insertions at a single center from 1994-2009 was performed. The following variables were evaluated: age (<1 year), comorbidities, omentectomy, concomitant gastrostomy, and laparoscopic technique. Multivariable Cox regressions analyses were used to evaluate patient survival and reoperation-free survival of PD catheters.
207 patients with a median age of 10 years underwent PD insertion. Mortality was 7% with a median follow up of 72 months. Reoperation for malfunction and infection was required in 49% of patients with a median PD catheter survival of 11 months. Reoperation for hernias occurred in 14% of patients. Multivariate Cox regressions analyses identified age <1 year, lack of omentectomy, concomitant gastrostomy, and prematurity as variables significantly associated with higher rates of mortality or reoperation.
In this large study of pediatric patients undergoing PD, higher complication rates were noted in infants less than one year of age. Concomitant gastrostomy was associated with a higher rate of reoperation for infection. Failure to perform omentectomy was associated with a higher rate of catheter failure.
由于腹膜透析（PD）是儿科人群首选的长期透析方式，我们旨在确定死亡和再次手术的风险因素。
对 1994 年至 2009 年在一家中心接受 PD 导管插入术的患者进行回顾性研究。评估了以下变量：年龄（<1 岁）、合并症、网膜切除术、同时进行胃造口术和腹腔镜技术。使用多变量 Cox 回归分析评估 PD 导管患者的生存和无再手术生存率。
207 名中位年龄为 10 岁的患者接受了 PD 插入术。死亡率为 7%，中位随访时间为 72 个月。49%的患者因故障和感染需要再次手术，PD 导管中位生存时间为 11 个月。14%的患者发生疝。多变量 Cox 回归分析确定年龄<1 岁、缺乏网膜切除术、同时进行胃造口术和早产是与死亡率或再次手术率较高相关的变量。
在这项对接受 PD 的儿科患者进行的大型研究中，1 岁以下婴儿的并发症发生率较高。同时进行胃造口术与更高的感染再手术率相关。未进行网膜切除术与导管失败率较高相关。
