腹膜透析导管植入：手术考虑因素、预期结果和并发症。
Peritoneal dialysis catheter embedment: surgical considerations, expectations, and complications.
机构信息
Department of Surgery, Southern California Permanente Medical Group, Kaiser Permanente Downey Medical Center, Downey, CA; Research and Evaluation Department, Kaiser Permanente Southern California, 100 South Los Robles Avenue, Pasadena, CA 91101, USA.
出版信息
Am J Surg. 2013 Oct;206(4):464-71. doi: 10.1016/j.amjsurg.2013.03.006. Epub 2013 Jul 12.
BACKGROUND
Peritoneal dialysis catheter embedment consists of implanting the catheter far in advance of anticipated need, with the external tubing buried under the skin. The catheter is externalized when initiation of dialysis is required. Details of the surgical procedure and management of associated complications are generally lacking.
METHODS
A total of 84 catheters including conventional and extended catheters were embedded and externalized during the study period. Factors influencing duration of embedment, functionality upon externalization, and long-term outcomes were analyzed.
RESULTS
Mean duration of embedment was 13.9 months (median 9.4; range .5 to 68.5). Immediate function was exhibited in 85.7% of catheters. Employing laparoscopic revision, 98.8% of embedded catheters were successfully used for peritoneal dialysis. Extended catheters and duration of embedment were important determinants of catheter functionality.
CONCLUSIONS
Catheters can be embedded for prolonged periods and still result in functional dialysis access when needed. Complications are few and easily managed.
背景
腹膜透析导管埋藏术是指在预期需要之前提前植入导管，并将外部管道埋在皮肤下。当需要开始透析时，将导管引出体外。该手术的详细过程和相关并发症的处理方法通常缺乏详细的报道。
方法
在研究期间，共埋藏和引出了 84 根导管，包括传统导管和延长导管。分析了影响埋藏时间、引出后功能和长期结果的因素。
结果
平均埋藏时间为 13.9 个月（中位数 9.4；范围 0.5 至 68.5）。85.7%的导管立即发挥功能。通过腹腔镜修正，98.8%的埋藏导管成功用于腹膜透析。延长导管和埋藏时间是导管功能的重要决定因素。
结论
导管可以长时间埋藏，在需要时仍能提供功能良好的透析通道。并发症很少且易于处理。
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