Grieff Marvin, Mamo Elizabeth, Scroggins Gina, Kurchin Alexander
Department of Medicine, Medical Library, Rochester General Hospital, Rochester, NY, USA
University of Rochester School of Medicine, Rochester, NY, USA.
Perit Dial Int. 2017 Mar-Apr;37(2):225-229. doi: 10.3747/pdi.2016.00152.
♦ BACKGROUND: The most commonly used peritoneal dialysis (PD) catheters have silicon tubing with attached Dacron cuffs. The current standard of care for PD catheter removal is by complete surgical dissection, withdrawing both the tubing and the cuffs. The intention is to avoid infection of any residual part of the catheter. We retrospectively analyzed our results with the alternative 'pull' technique, by which the silicon tube is pulled out, leaving the Dacron cuffs within the abdominal wall. This technique never gained popularity due to concern that the retained cuffs would get infected. ♦ METHODS: We reviewed our experience from an 18-month period, between January 2014 and June 2015. There were 46 catheter removals in 40 patients. All the catheters were of the double-cuffed coiled Tenckhoff type (Covidien, Dublin, Ireland). ♦ RESULTS: Of the 46 catheter removals by the 'pull' technique, there was only 1 case of retained cuff infection. ♦ CONCLUSIONS: The 'pull' technique is a safe method for Tenckhoff catheter removal with low risk of infection. We strongly recommend it as the procedure of choice.
♦ 背景：最常用的腹膜透析（PD）导管是带有涤纶套的硅胶管。目前PD导管拔除的标准护理方法是通过完全手术剥离，拔出导管和涤纶套。目的是避免导管任何残留部分发生感染。我们回顾性分析了采用另一种“牵拉”技术的结果，即拔出硅胶管，将涤纶套留在腹壁内。由于担心残留的涤纶套会被感染，这种技术从未流行起来。♦ 方法：我们回顾了2014年1月至2015年6月这18个月期间的经验。40例患者中有46次导管拔除。所有导管均为双套盘绕式Tenckhoff型（Covidien，都柏林，爱尔兰）。♦ 结果：在通过“牵拉”技术拔除的46根导管中，仅有1例发生了残留涤纶套感染。♦ 结论：“牵拉”技术是拔除Tenckhoff导管的一种安全方法，感染风险低。我们强烈推荐将其作为首选方法。
