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腹膜透析导管插入术中并发症与技术存活率的比较分析:单荷包缝合与双荷包缝合

Comparative analysis of complications and technique survival in peritoneal dialysis catheter insertion: single purse-string suture vs. double purses-string suture.

作者信息

Li Xiaoling, Chen Xiuling, Gao Hui, Zhou Qin, Liu Wenshu, Li Pengli, Li Yan, Wang Shiwen, Chen Jin, Li Guisen

机构信息

Department of Nephrology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

出版信息

Ren Fail. 2024 Dec;46(2):2435209. doi: 10.1080/0886022X.2024.2435209. Epub 2024 Dec 11.

DOI:10.1080/0886022X.2024.2435209
PMID:39659240
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11748857/
Abstract

OBJECTIVE

Single- and double-purse-string suture methods are both widely used in open surgical catheterization for peritoneal dialysis. This study aimed to compare the post-insertion complications and technical survival of the two methods.

METHODS

This retrospective study matched 142 patients who underwent peritoneal catheterization using the single- (Group S) or double- (Group D) purse-string suture method. Baseline clinical data and complications were recorded, and technical and patient survival rates were evaluated over 3 years.

RESULTS

There were no significant intergroup differences in terms of infection complication rates (S, 2.8% D, 5.6%,  = 0.377) or non-infection complication rates (2.1% 2.8%,  = 1.000) within the first month post-insertion. The Kaplan-Meier estimates of technical survival at 1, 2, and 3 years were 96.3%, 90.4%, and 85.9% in group S and 89.9%, 86.7%, and 84.8% in group D, respectively (log-rank test,  = 0.439). Additionally, patient survival rates were comparable between groups over the 3-year follow-up (log-rank test,  = 0.647).

CONCLUSIONS

This study revealed that the single- and double-purse-string suture catheter insertion methods have similar post-insertion complication and technical survival rates. These data suggest that the single-purse-string suture method can be adopted as standard practice for peritoneal dialysis catheter placement.

摘要

目的

单荷包缝合和双荷包缝合方法在腹膜透析开放手术置管中均被广泛应用。本研究旨在比较两种方法置管后的并发症及技术生存率。

方法

本回顾性研究纳入了142例行腹膜置管术的患者,其中采用单荷包缝合方法的为S组,采用双荷包缝合方法的为D组。记录基线临床数据及并发症情况,并评估3年期间的技术生存率和患者生存率。

结果

置管后第一个月内,两组在感染并发症发生率(S组为2.8%,D组为5.6%,P = 0.377)或非感染并发症发生率(2.1%对2.8%,P = 1.000)方面无显著组间差异。S组1年、2年和3年的技术生存Kaplan-Meier估计值分别为96.3%、90.4%和85.9%,D组分别为89.9%、86.7%和84.8%(对数秩检验,P = 0.439)。此外,在3年随访期间,两组的患者生存率相当(对数秩检验,P = 0.647)。

结论

本研究表明,单荷包缝合和双荷包缝合导管插入方法在置管后并发症及技术生存率方面相似。这些数据表明,单荷包缝合方法可作为腹膜透析导管置入的标准操作方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22c6/11748857/a9d6ffccfb2a/IRNF_A_2435209_F0002_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22c6/11748857/4bd7035903a5/IRNF_A_2435209_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22c6/11748857/a9d6ffccfb2a/IRNF_A_2435209_F0002_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22c6/11748857/4bd7035903a5/IRNF_A_2435209_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22c6/11748857/a9d6ffccfb2a/IRNF_A_2435209_F0002_B.jpg

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Kidney Int Rep. 2023 Sep 17;8(12):2635-2645. doi: 10.1016/j.ekir.2023.09.015. eCollection 2023 Dec.
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Inpatient peritoneal dialysis catheters placed across the United States during a 3-year period: Lessons learned from 15,000 patients.在过去 3 年期间,美国使用的经皮腹膜透析导管:15000 例患者的经验教训。
Surgery. 2024 Mar;175(3):877-884. doi: 10.1016/j.surg.2023.09.058. Epub 2023 Nov 10.
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Comparing surgeon- and nephrologist-inserted Tenckhoff catheters: experience from a metropolitan centre in Sydney.
比较外科医生和肾病科医生置入的Tenckhoff导管:来自悉尼一个大都市中心的经验。
Intern Med J. 2023 Oct;53(10):1890-1895. doi: 10.1111/imj.15995. Epub 2022 Dec 27.
4
Ultrasound-Guided Modified Seldinger Placement of Tenckhoff Catheters in Pediatric Patients Undergoing Peritoneal Dialysis: Single Center Experience.超声引导下改良塞丁格技术在接受腹膜透析的儿科患者中置入Tenckhoff导管:单中心经验
Front Pediatr. 2022 Jun 30;10:917720. doi: 10.3389/fped.2022.917720. eCollection 2022.
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Perit Dial Int. 2021 Nov;41(6):552-563. doi: 10.1177/0896860820966898. Epub 2020 Oct 27.
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Different techniques for peritoneal dialysis catheter implantation: A systematic review and network meta-analysis.不同的腹膜透析导管植入技术:系统评价和网络荟萃分析。
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