Shahbandari Morteza, Amiran Alireza
Department of General Surgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2019 Sep 30;24:85. doi: 10.4103/jrms.JRMS_1097_18. eCollection 2019.
Invention of peritoneal dialysis (PD) has opened new windows for patients under dialysis due to its fewer time requirement and being ambulatory in comparison to hemodialysis. Open surgery and laparoscopic technique have been utilized for peritoneal catheter embedding; however, data about the superior technique are controversial. This study aimed to assess the outcomes of open surgery versus laparoscopic technique and compare their complications in those with survival of over and less than a year in patients who need PD for the first time.
This randomized clinical trial study was conducted on 121 cases admitted for PD. Patients were randomly divided into two groups undergoing either open or laparoscopic surgery for embedding PD catheter. Patients' demographics, as well as PD function and complications, were followed for a 12-month duration and compared between the two groups.
Catheter survival for over 12 months occurred in 39 patients (65%) underwent laparoscopic surgery, and 45 (73.8%) patients underwent open surgery ( = 0.09). Complications, including catheter obstruction, leak, abdominal hernia, and peritonitis, were not statistically different between the two techniques over 12 months of survival ( > 0.05). Complications among the catheters with less than a year survival, including obstruction, leak, catheter displacement, hernia, and peritonitis, were not significantly different comparing open surgery with laparoscopic technique ( > 0.05).
Considering complications, PD catheter implantation through laparoscopic surgery was not statistically different from open surgery, neither for those with less than 12 months of survival nor for those with over a year.
腹膜透析（PD）的发明为透析患者打开了新的窗口，因为与血液透析相比，其所需时间更少且可门诊进行。开放手术和腹腔镜技术已被用于腹膜导管植入；然而，关于哪种技术更优的数据存在争议。本研究旨在评估开放手术与腹腔镜技术的结果，并比较首次需要腹膜透析的患者中生存超过一年和不足一年者的并发症情况。
本随机临床试验研究针对121例因腹膜透析入院的患者进行。患者被随机分为两组，分别接受开放手术或腹腔镜手术植入腹膜透析导管。对患者的人口统计学资料以及腹膜透析功能和并发症进行为期12个月的随访，并在两组之间进行比较。
接受腹腔镜手术的39例患者（65%）导管存活超过12个月，接受开放手术的45例患者（73.8%）导管存活超过12个月（P = 0.09）。在12个月的生存期内，包括导管阻塞、渗漏、腹疝和腹膜炎在内的并发症在两种技术之间无统计学差异（P>0.05）。在存活不足一年的导管中，包括阻塞、渗漏、导管移位、疝和腹膜炎在内的并发症，开放手术与腹腔镜技术相比无显著差异（P>0.05）。
考虑到并发症，腹腔镜手术植入腹膜透析导管与开放手术相比，在存活不足12个月的患者和存活超过一年的患者中均无统计学差异。
