Alexander S R, Tank E S
J Urol. 1982 Mar;127(3):501-4. doi: 10.1016/s0022-5347(17)53885-9.
The importance of surgical contributions to successful pediatric continuous ambulatory peritoneal dialysis demonstrated in this review of our experience with 9 pediatric patients maintained on such dialysis for 2 to 21 months (mean 11.3 months). Specific surgical procedures for pediatric peritoneal catheter placement have been developed that ensure proper catheter position, establish a watertight seal at the peritoneum and provide for intraoperative demonstration of good catheter function. Peritoneography at the time of catheter placement had predicted accurately later clinical hernia development and may be used to repair prophylactically subclinical inguinal and umbilical defects that are only demonstrable by intraoperative peritoneography. Partial omentectomy also has been helpful in certain instances. Since institution of the techniques described in this report, our 9 young patients have accumulated 101 patient-months on continuous ambulatory peritoneal dialysis without a single catheter failure. The benefits of this as yet unrestricted extension of peritoneal catheter functional life span may be attributed to the catheter-protective features of the continuous ambulatory peritoneal dialysis method itself and the involvement of interested surgeons as active members of the pediatric continuous ambulatory peritoneal dialysis program.
本综述通过对9例接受持续非卧床腹膜透析2至21个月（平均11.3个月）的儿科患者的经验，证明了外科手术对成功进行儿科持续非卧床腹膜透析的重要性。已开发出用于儿科腹膜导管置入的特定外科手术方法，可确保导管位置正确，在腹膜处建立水密密封，并在术中证明导管功能良好。导管置入时的腹膜造影可准确预测后期临床疝的发生，可用于预防性修复仅在术中腹膜造影时才可显示的亚临床腹股沟和脐部缺损。在某些情况下，部分大网膜切除术也很有帮助。自采用本报告所述技术以来，我们的9名年轻患者在持续非卧床腹膜透析中累计了101个患者月，没有一次导管故障。这种腹膜导管功能寿命尚未受限的延长所带来的益处，可能归因于持续非卧床腹膜透析方法本身的导管保护特性，以及相关外科医生作为儿科持续非卧床腹膜透析项目的积极成员的参与。
