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Correction of CAPD catheter displacement using alpha-replacement method
Shinya Kawamoto1, Hiroyasu Yamamoto, Masaaki Nakayama
1Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University Daisan Hospital, 4-11-1 Izumihonchou, Komae, Tokyo 201-8601, Japan. kawapon@jikei.ac.jp
Background:
Malposition of the tip of a continuous ambulatory peritoneal dialysis (CAPD) catheter may impede a dialysis, and an invasive method, such as open or laparoscopic surgery, is necessary to correct its position. The alpha-replacement method is a nonsurgical procedure; however, the reported clinical experience has been limited. We thus reviewed our 19 cases to clarify the efficacy of this method.
Method:
The alpha-replacement method was used in 19 patients [mean age, 50 +/- 14 years old; male/female ratio, 13/6; duration of catheter insertion, 23.7 +/- 23.9 months; total, 29 times in 19 patients (once in 13 patients, twice in 3, three times in 2, four times in 1 patient)]. All patients received a swan-neck J-type catheter. The procedure was carried out by using a special guidewire within 1-2 weeks after dislocation of the tips.
Results:
The procedure was successfully performed 22 times in 14 patients (success rate, 78% in each performance). Required time was only 5-10 min in most successful cases. No evident complications were encountered in any case.
Conclusions:
The alpha-replacement method for a displaced CAPD catheter proved to be effective and safe.
