Renal Department, 2379Gloucester Royal Hospital, Gloucester, UK.
Hilton Life Hospital, Pietermaritzburg, South Africa.
Perit Dial Int. 2021 Nov;41(6):578-580. doi: 10.1177/08968608211035949. Epub 2021 Aug 6.
Peritoneal dialysis (PD) is a modality frequently preferred by patients for the management of their end-stage kidney disease; however, a major factor in its success is PD catheter placement and subsequent function. Optimal placement of PD catheters is generally accepted to be in the true pelvis, for this reason, many patients who are found to have a pelvic cavity obliterated by adhesions are often denied the opportunity to do PD. We report on four cases of an alternative advanced laparoscopic technique used in patients with inaccessible pelvic cavities, with three catheter placements in the intraperitoneal left iliac fossa/paracolic gutter and one case in the right paracolic gutter with subsequent good outcomes. This report suggests that a 'frozen pelvis' is not a contraindication to successful PD, with alternative catheter tip placement in the iliac fossa.
腹膜透析（PD）是一种经常被终末期肾病患者选择的治疗方法；然而，其成功的一个主要因素是 PD 导管的放置和后续功能。通常认为 PD 导管的最佳放置位置是在真正的骨盆中，因此，许多被发现由于粘连而导致盆腔消失的患者往往被剥夺了进行 PD 的机会。我们报告了四种在无法进入的盆腔患者中使用的替代先进腹腔镜技术的案例，其中 3 例导管放置在腹腔左侧髂窝/结肠旁沟，1 例在右侧结肠旁沟，随后结果良好。本报告表明，“冰冻骨盆”并不是 PD 成功的禁忌症，可以选择将导管尖端放置在髂窝。
