Kao Chun-Yu, Chuang Jiin-Haur, Lee Shin-Yi
Department of Pediatric Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Perit Dial Int. 2014 Jan-Feb;34(1):109-13. doi: 10.3747/pdi.2012.00130. Epub 2013 Oct 1.
Various techniques for laparoscopic insertion of a peritoneal dialysis catheter have been described. Usually 2 - 3 ports are required, and complications related to the port sites (such as abdominal wall hernia, leakage, and hemorrhage) cannot be avoided. To minimize the potential complications, we designed a simplified 1-port laparoscopic technique for peritoneal dialysis catheter placement. ♢
We conducted a retrospective data review of 44 patients who underwent 1-port laparoscopic insertion of a Tenckhoff catheter from June 2009 to February 2011. All patient data, including postoperative complications, were analyzed. ♢
The mean follow-up period was 11.52 months. All catheters were working properly, except in 1 patient who developed peritonitis 3 months after catheter placement. (The catheter was removed.) No postoperative abdominal wall hemorrhage, early leaks, hernias, or catheter migration occurred. No exit-site or tunnel infections were observed. ♢
Our 1-port laparoscopic technique provides excellent catheter fixation, avoids excessive port sites, and yields good cosmesis. The low complication rate and the simplicity of the method justify its standard use for Tenckhoff catheter placement.
已有多种腹腔镜置入腹膜透析导管的技术被描述。通常需要2至3个穿刺孔,且与穿刺孔部位相关的并发症(如腹壁疝、渗漏和出血)难以避免。为使潜在并发症降至最低,我们设计了一种简化的单孔腹腔镜技术用于腹膜透析导管置入。♢
我们对2009年6月至2011年2月期间接受单孔腹腔镜置入Tenckhoff导管的44例患者进行了回顾性数据审查。分析了所有患者的数据,包括术后并发症。♢
平均随访期为11.52个月。除1例患者在导管置入3个月后发生腹膜炎(导管被拔除)外,所有导管均正常工作。未发生术后腹壁出血、早期渗漏、疝或导管移位。未观察到出口部位或隧道感染。♢
我们的单孔腹腔镜技术能实现良好的导管固定,避免过多的穿刺孔部位,并具有良好的美容效果。该方法的低并发症发生率和简便性证明其可作为Tenckhoff导管置入的标准方法。