Pan Alan, Poi Mun J, Matos Jesus, Jiang Jenny S, Kfoury Elias, Echeverria Angela, Bechara Carlos F, Lin Peter H
Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
Department of Cardiothoracic and Vascular Surgery, Houston Methodist Hospital, Houston, TX, USA.
Vasc Endovascular Surg. 2016 Jul;50(5):343-8. doi: 10.1177/1538574416652245. Epub 2016 Jun 2.
Laparoscopic insertion of peritoneal dialysis (PD) catheter has become a preferred method compared to the traditional open technique for PD catheter insertion. We retrospectively report the outcome of 1-port laparoscopic placement PD catheters in our institution.
A total of 263 patients with end-stage renal disease who underwent single-trocar laparoscopic PD catheter insertion during a recent 6-year period were reviewed. Laparoscopic technique involves introducing a PD catheter over a stiff guidewire into the abdominal cavity through a 10-mm laparoscopic port. Pertinent clinical variables, procedural complications, and follow-up outcome were analyzed.
There were 182 men and 81 women. The mean age was 56 years. Technical success was 95.8%. Catheter occlusion was the most common early complications (<6 months) that occurred in 4 (1.5%) patients. Late complications (> 6 months) including catheter occlusion, cuff extrusion, catheter leakage, catheter migration, infection, and hernia occurred in 5 patients (1.9%), 2 patients (0.8%), 3 patients (1.1%), 3 patients (1.1%), 6 patients (2.3%), and 4 patients (1.5), respectively. Mean follow-up time was 39 ± 18 months. Catheter survival rate at 1, 2, 3, 4, and 5 years was 96%, 94%, 90%, 85%, and 82%, respectively.
Laparoscopic PD catheter implantation via a single-trocar utilizing a stiff guidewire technique is feasible and safe. This method can result in low complication and high catheter survival rate.
与传统的开放式腹膜透析（PD）导管插入技术相比，腹腔镜插入PD导管已成为一种首选方法。我们回顾性报告了我院单孔腹腔镜放置PD导管的结果。
回顾了最近6年期间共263例接受单孔腹腔镜PD导管插入术的终末期肾病患者。腹腔镜技术包括通过一根硬导丝将PD导管经一个10毫米的腹腔镜端口引入腹腔。分析了相关的临床变量、手术并发症和随访结果。
男性182例，女性81例。平均年龄56岁。技术成功率为95.8%。导管堵塞是最常见的早期并发症（<6个月），发生在4例（1.5%）患者中。晚期并发症（>6个月）包括导管堵塞、袖套挤出、导管渗漏、导管移位、感染和疝气，分别发生在5例（1.9%）、2例（0.8%）、3例（1.1%）、3例（1.1%）、6例（2.3%）和4例（1.5%）患者中。平均随访时间为39±18个月。1年、2年、3年、4年和5年的导管生存率分别为96%、94%、90%、85%和82%。
通过单孔利用硬导丝技术进行腹腔镜PD导管植入是可行且安全的。该方法可导致低并发症和高导管生存率。
