Department of Nephrology, Affiliated Wujin Hospital of Jiangsu University, No. 85 Gehu East Road, Wujin District, Changzhou, 213002, Jiangsu, China.
Int Urol Nephrol. 2019 Jun;51(6):1053-1058. doi: 10.1007/s11255-019-02164-8. Epub 2019 May 14.
Peritoneal dialysis (PD) catheter tip migration accounts for the majority of cases of PD catheter malfunction. In this case series, we described our experiences of using a modified PD catheter implantation approach through a site that is lower than the site that is conventionally used, to reduce catheter malfunction.
We retrospectively identified 76 patients who received PD catheter implantation at the Affiliated Wujin Hospital of Jiangsu University, among whom 39 received the traditional approach of low-site insertion and 37 received a modified approach of very-low-site insertion. All participants were followed up for at least 2 years after PD catheter implantation, and the development of catheter dysfunction or death during this period was monitored.
We found that the survival rate of the initially inserted catheter was 75.68% among the very-low-site group. This survival rate was significantly better than that observed among the low-site group (48.72%; p = 0.029). Kaplan-Meier curves of the initial catheter survival also showed that the catheter survival was significantly higher in the patients in the very-low-site group than those in the low-site group (log rank p = 0.012). Complications, such as catheter tip migration, were not observed in the very-low-site group, while tip migration occurred in 15.38% of the patients in the low-site group (very-low-site group vs low-site group: p = 0.039).
A safe and simple PD catheter implantation can be performed either through the low-site approach or the very-low-site approach.
腹膜透析（PD）导管尖端迁移是 PD 导管功能障碍的主要原因。在本病例系列中，我们描述了使用改良 PD 导管植入方法的经验，该方法通过低于传统使用部位的部位进行植入，以减少导管功能障碍。
我们回顾性确定了在江苏大学附属武进医院接受 PD 导管植入的 76 名患者，其中 39 名接受传统的低位插入方法，37 名接受改良的超低位插入方法。所有参与者在 PD 导管植入后至少随访 2 年，并监测在此期间导管功能障碍或死亡的发展情况。
我们发现超低位组的初始插入导管的存活率为 75.68%。该存活率明显优于低位组（48.72%；p=0.029）。初始导管存活的 Kaplan-Meier 曲线也表明，超低位组的导管存活率明显高于低位组（log rank p=0.012）。超低位组未观察到导管尖端迁移等并发症，而低位组有 15.38%的患者发生尖端迁移（超低位组与低位组：p=0.039）。
通过低位或超低位方法都可以进行安全简单的 PD 导管植入。
