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Delayed complications following Tenckhoff catheter removal
J J Elkabir1, A A Riaz, S K Agarwal
1Department of Urology, Hammersmith Hospital, London, UK.
Summary
Removing Tenckhoff catheters by traction can lead to retained cuffs and local sepsis. Dissection and excision of both cuffs are recommended to prevent post-removal complications in continuous ambulatory peritoneal dialysis (CAPD) patients.
Area of Science:
- Nephrology
- Surgical Complications
- Medical Device Management
Background:
- Tenckhoff catheter placement is standard for continuous ambulatory peritoneal dialysis (CAPD) in end-stage renal failure.
- While in situ complications are known, post-removal issues are less documented.
- Many centers remove catheters by traction, leaving cuffs in place, unlike formal dissection.
Purpose of the Study:
- To evaluate the outcomes of Tenckhoff catheter removal by traction over a two-year period.
- To identify the incidence and nature of post-removal complications.
- To compare traction removal with dissection for Tenckhoff catheters.
Main Methods:
- Retrospective analysis of 62 patients undergoing Tenckhoff catheter removal by traction.
- Review of case notes and operation records for patient evaluation.
- Assessment of complications occurring after catheter removal.
Main Results:
- Catheters were in situ for a mean of 23 months; primary removal reason was peritonitis (48.4%).
- Fifteen patients (24.2%) developed local infective complications, primarily involving the subcutaneous cuff.
- Immunosuppression was not found to be a risk factor for retained cuff infections.
Conclusions:
- Traction removal of Tenckhoff catheters poses a significant risk of local sepsis due to retained cuffs.
- Infection complications can occur months after removal.
- Surgical removal by dissection and excision of both cuffs is recommended to mitigate these risks.