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经高级腹腔镜手术置放腹膜透析导管:来自中国一家医学中心的 8 年经验。

Peritoneal Dialysis Catheter Emplacement by Advanced Laparoscopy: 8-year Experience from a Medical Center of China.

机构信息

Department of Nephrology, Shunde Hospital of Southern Medical University, Shunde, 528300, China.

Gastro-entero-pancreatic laparoscopic training centre, Shunde Hospital of Southern Medical University, Shunde, 528300, China.

出版信息

Sci Rep. 2017 Aug 22;7(1):9097. doi: 10.1038/s41598-017-09596-1.

DOI:10.1038/s41598-017-09596-1
PMID:28831180
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5567303/
Abstract

Laparoscopic experience and relevant reports about PD catheter emplacement in Chinese patients are seldom. In this study, we described our experience with advanced laparoscopy for PD catheter implantation in Chinese patients. There were one hundred and thirty Chinese patients accepted advanced laparoscopic approach for PD catheter emplacement in this study. Six of 26 patients with prior abdominal operations had abdominal adhesion, while six of 104 patients without prior abdominal surgeries showed abdominal adhesion. Operation time required 10 to 180 minutes. During a mean follow-up time of 26.46 months, the catheter complications were shown as outflow obstruction (n = 6, 4.62%), pericatheter leaking (n = 3, 2.31%), hydrocele of tunica vaginalis (n = 1, 0.77% in all), and umbilical hernia (n = 2, 1.54%). Cumulative revision-free survival probability for catheter loss from mechanical complications at 8 years was 0.95. During the postoperative follow-up ranged between 6 and 106 months, 98 patients (75.38%) were still on CAPD, 17 patients (13.08%) died, 8 patients (6.15%) were transferred to hemodialysis, 6 patients (4.62%) received kidney transplantation, and 1 patient (0.77%) showed improved renal function. These results showed that PD catheter placement with advanced laparoscopy is a safe and effective approach in Chinese patients with or without prior abdominal surgeries.

摘要

腹腔镜技术在我国的发展相对较晚,目前仅有少量关于经腹腔镜置管术治疗 PD 的相关报道。本研究旨在探讨经腹腔镜置管术在我国 PD 患者中的应用经验。

本研究共纳入 130 例接受经腹腔镜置管术的 PD 患者。26 例有腹部手术史的患者中,6 例存在腹部粘连;104 例无腹部手术史的患者中,6 例存在腹部粘连。手术时间为 10180 min。在平均 26.46 个月的随访期间,导管并发症包括出口梗阻 6 例(4.62%)、导管周围漏液 3 例(2.31%)、鞘膜积液 1 例(0.77%)和脐疝 2 例(1.54%)。8 年时机械性并发症导致的导管丢失累积无返修生存率为 0.95。术后随访 6106 个月,98 例(75.38%)患者仍继续接受 CAPD 治疗,17 例(13.08%)患者死亡,8 例(6.15%)患者转为血液透析,6 例(4.62%)患者接受了肾移植,1 例(0.77%)患者肾功能改善。

这些结果表明,经腹腔镜置管术治疗 PD 是一种安全有效的方法,适用于有或无腹部手术史的我国 PD 患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5c4/5567303/b921dcf1dab8/41598_2017_9596_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5c4/5567303/b921dcf1dab8/41598_2017_9596_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5c4/5567303/b921dcf1dab8/41598_2017_9596_Fig1_HTML.jpg

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本文引用的文献

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Peritoneal Dialysis Catheter Insertion.腹膜透析导管插入术
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Laparoscopic peritoneal dialysis catheter placement is associated with decreased deep organ infection and reoperation.腹腔镜下腹膜透析导管置入术与深部器官感染及再次手术的减少有关。
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