Di Paolo N, Petrini G, Garosi G, Buoncristiani U, Brardi S, Monaci G
Nephrology and Dialysis Department, Regional Hospital of Siena, Italy.
Perit Dial Int. 1996 Nov-Dec;16(6):623-7.
Peritoneal catheters often become dislocated, and this may lead to malfunction. Since it is not usually possible to bring them back into their correct position, they must be replaced. With the aim of preventing this complication, we designed a new catheter.
The new catheter has the same form as the Tenckhoff catheter except for a small increase in external diameter of the last 2 cm, made possible by the high specific weight of a small 12-g tungsten cylinder incorporated in the Silastic at the abdominal end. The new catheter may be inserted by a percutaneous technique.
University hospitals of Siena and Perugia, Italy.
In the last three years, 32 of these catheters have been implanted for a total experience of 468 patient-months. Their position was checked on insertion and every two months thereafter by radiography; 26 Tenckhoff catheters (415 patient-months) were studied at the same time. Insertion was performed surgically and by a percutaneous method. The frequency of cuff extrusion, exit-site infections, leakage, and peritoneal infection were noted, together with peritoneal function, which was evaluated by KT/V and weekly creatinine clearance one month after catheter insertion; the tests were repeated when dislocation occurred and at the end of the trial.
No dislocations occurred with the self-locating catheters, whereas nine dislocations occurred in control patients (p = 0.0003). There were no significant differences with respect to controls for cuff extrusion, exit-site infections, leakage, peritoneal infection, and peritoneal function.
The presence of a small weight at the catheter up prevents displacement completely, keeping the intraperitoneal part of the catheter in place.
腹膜导管常发生移位，这可能导致功能障碍。由于通常无法将其恢复到正确位置，因此必须更换导管。为预防这一并发症，我们设计了一种新型导管。
新型导管与Tenckhoff导管形状相同，只是最后2厘米的外径略有增加，这是通过在腹部末端的硅橡胶中嵌入一个小的12克钨圆柱体的高比重实现的。新型导管可通过经皮技术插入。
意大利锡耶纳和佩鲁贾的大学医院。
在过去三年中，已植入32根此类导管，总计有468个患者月的使用经验。在插入时以及此后每两个月通过放射检查导管位置；同时研究了26根Tenckhoff导管（415个患者月）。插入操作通过手术和经皮方法进行。记录袖套挤出、出口部位感染、渗漏和腹膜感染的频率，以及腹膜功能，腹膜功能在导管插入后一个月通过KT/V和每周肌酐清除率进行评估；当发生移位时以及试验结束时重复这些测试。
自定位导管未发生移位，而对照患者发生了9次移位（p = 0.0003）。在袖套挤出、出口部位感染、渗漏、腹膜感染和腹膜功能方面与对照组无显著差异。
导管末端的小重量可完全防止移位，使导管的腹膜内部分保持在原位。
