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初步报告:膀胱镜辅助下腹膜透析导管置入术——一种直接、可视、安全、精确、简便、微创且经济的技术。

Preliminary report: cystoscopy-assisted peritoneal dialysis catheter placement - a direct, visual, safe, precise, easy, minimally invasive, and inexpensive technique.

作者信息

Qian Xiaoqiang, Qi Jun

机构信息

Department of Urology, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.

出版信息

Clin Nephrol. 2014 Apr;81(4):247-50. doi: 10.5414/cn108175.

Abstract

OBJECTIVE

We introduce a new method of peritoneal dialysis (PD) catheter placement with cystoscopic assistance. It has clear advantages compared with conventional open surgery.

MATERIALS AND METHODS

Patients with end-stage renal disease (ESRD) were randomly divided into two groups. Group A (14 patients) underwent cystoscopy-assisted surgery, and group B (15 patients) underwent conventional open surgery for the PD catheter placement. Continuous ambulatory PD training was started 14 days after surgery in both groups. We evaluated the differences between the two groups prospectively.

RESULTS

Both groups had no difference in demographics including age, male/female ratio, previous abdominal surgery percent, and cause of ESRD (p > 0.05). All catheters were placed successfully without mortality. Group A had better surgery-related data: local anesthesia rate, VAS (Visual Analogue Score), incisional length, and hospital stay were significantly different compared with group B (p < 0.05). And the blood loss duration surgery and duration of surgery were not significantly different (p > 0.05). In group A, there was no case of catheter obstruction and migration, dialysate leak, exit site infection, or incisional hernia. There was only one peritonitis case in group A. Compared with group B, the total surgical complications difference was significant (p < 0.05).

CONCLUSION

Cystoscopy-assisted PD catheter placement is a direct, visual, safe, precise, easy, inexpensive, and minimally invasive technique that is ideal for patients with ESRD.

摘要

目的

我们介绍一种在膀胱镜辅助下进行腹膜透析(PD)导管置入的新方法。与传统开放手术相比,它具有明显优势。

材料与方法

终末期肾病(ESRD)患者被随机分为两组。A组(14例患者)接受膀胱镜辅助手术,B组(15例患者)接受传统开放手术置入PD导管。两组均在术后14天开始持续非卧床腹膜透析训练。我们前瞻性地评估了两组之间的差异。

结果

两组在人口统计学特征上无差异,包括年龄、男女比例、既往腹部手术比例和ESRD病因(p>0.05)。所有导管均成功置入,无死亡病例。A组有更好的手术相关数据:局部麻醉率、视觉模拟评分(VAS)、切口长度和住院时间与B组相比有显著差异(p<0.05)。且术中失血量和手术时间无显著差异(p>0.05)。A组无导管梗阻、移位、透析液渗漏、出口处感染或切口疝病例。A组仅1例腹膜炎病例。与B组相比,手术总并发症差异有统计学意义(p<0.05)。

结论

膀胱镜辅助下PD导管置入是一种直接、可视、安全、精确、简便、廉价且微创的技术,对ESRD患者来说是理想的选择。

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