Department of Pediatric Surgery, Hospital Fundación HOMI, Universidad Nacional de Colombia, Bogotá, Colombia.
Department of General Surgery Universidad El Bosque, Semillero de Investigación en Cirugía General y Subespecialidades, Bogotá, Colombia.
J Laparoendosc Adv Surg Tech A. 2023 Nov;33(11):1121-1125. doi: 10.1089/lap.2022.0315. Epub 2023 Aug 8.
Peritoneal dialysis (PD) is a frequent method for renal replacement therapy in pediatric population. However, PD is associated with a high incidence of early and late complications. Thus, this study aims to evaluate the perioperative factors associated with these complications. Clinical records of patients who had peritoneal dialysis catheter (PDC) placement between January 2013 and June 2016 were retrospectively analyzed. Sociodemographic and perioperative variables were recorded and analyzed. A total of 92 patients required PDC insertion. Primary PDC failure occurred in 21.74% of cases, and 17.39% required reoperation. The most common complication was occlusion (13.04%), followed by leak (8.7%). Age younger than 1 year and weight less than 10 kg were significant risk factors for catheter dysfunction, reoperation, leak, PDC occlusion, hernia, and death. The open technique was associated with higher risks of operation, leak, and peritonitis than the laparoscopic technique. Placement of the catheter by the laparoscopic technique reduced the odds of occlusion by 38%. Patients younger than 1 year and weighing less than 10 kg have an increased risk of complications and death, regardless of the technique used. The most frequent complication is catheter failure; however, the laparoscopic technique appears to reduce this complication.
腹膜透析(PD)是儿科人群肾脏替代治疗的常用方法。然而,PD 与早期和晚期并发症的高发生率相关。因此,本研究旨在评估与这些并发症相关的围手术期因素。
回顾性分析了 2013 年 1 月至 2016 年 6 月期间接受腹膜透析导管(PDC)置管的患者的临床记录。记录并分析了社会人口统计学和围手术期变量。
共有 92 名患者需要插入 PDC。原发性 PDC 失败的发生率为 21.74%,17.39%需要再次手术。最常见的并发症是阻塞(13.04%),其次是渗漏(8.7%)。年龄小于 1 岁和体重小于 10kg 是导管功能障碍、再次手术、渗漏、PDC 阻塞、疝和死亡的显著危险因素。与腹腔镜技术相比,开放技术与更高的手术、渗漏和腹膜炎风险相关。与开放技术相比,腹腔镜技术可将导管阻塞的几率降低 38%。
无论使用哪种技术,年龄小于 1 岁和体重小于 10kg 的患者发生并发症和死亡的风险增加。最常见的并发症是导管功能障碍;然而,腹腔镜技术似乎可以降低这种并发症的发生。