Barone G W, Johnson D D, Webb J W
Department of Surgery, University of Arkansas for Medical Sciences, Little Rock 72205, USA.
J Laparoendosc Adv Surg Tech A. 1998 Feb;8(1):19-23. doi: 10.1089/lap.1998.8.19.
Peritoneal dialysis is widely accepted for the chronic management of end-stage renal disease but is associated with as high as a 70% complication rate including a significant problem with peritoneal dialysis catheter flow obstruction. The application of laparoscopic surgical techniques has revolutionized the surgical approach to peritoneal dialysis catheter-related dysfunction. However, the specific laparoscopic surgical technique varied among the reported literature. This lack of a standard laparoscopic surgical approach to obstructed peritoneal dialysis catheters prompted us to review and compare our specific technique and experience in 17 patients with 10 recent reported series. We specifically examined for insufflation techniques, access port placements and closures, timing postoperatively for reinstituting peritoneal dialysis, wound complications, and overall long-term success rates for peritoneal dialysis catheter salvage.
腹膜透析被广泛用于终末期肾病的慢性管理，但并发症发生率高达70%，包括腹膜透析导管流量梗阻这一重大问题。腹腔镜手术技术的应用彻底改变了腹膜透析导管相关功能障碍的手术治疗方法。然而，在已发表的文献中，具体的腹腔镜手术技术各不相同。由于缺乏针对梗阻性腹膜透析导管的标准腹腔镜手术方法，我们对17例患者的具体技术和经验进行了回顾，并与最近报道的10个系列进行了比较。我们特别检查了气腹技术、穿刺孔的放置和闭合、术后恢复腹膜透析的时间、伤口并发症以及腹膜透析导管挽救的总体长期成功率。
