Percutaneous continuous ambulatory peritoneal dialysis (CAPD) catheter insertion--a preferred option for developing...

Area of Science:

• Nephrology
• Surgical Procedures
• Renal Replacement Therapy

Background:

• Continuous ambulatory peritoneal dialysis (CAPD) is a vital home-based renal replacement therapy for chronic kidney disease stage 5 (CKD 5).
• Percutaneous catheter placement is emerging as an alternative to open surgery for CAPD access.
• CAPD is preferred for patients with limited hemodialysis access or specific viral infections.

Purpose of the Study:

• To evaluate the safety and efficacy of blind percutaneous insertion of swan neck, double-cuffed Tenckhoff CAPD catheters using a trocar.
• To assess the impact on hospital stay and surgical costs.
• To document the complication rates associated with this technique.

Main Methods:

• Retrospective review of CAPD catheter insertions over two years.
• Utilized blind insertion technique with a trocar for swan neck, double-cuffed Tenckhoff catheters.
• Monitored patient outcomes, including complications, hospital stay, and costs.

Main Results:

• Significant reduction in hospital stay and surgical costs observed.
• One major complication: injury to the jejunal mesenteric artery requiring laparotomy.
• Three cases of inadequate fluid drainage due to omental wrapping, necessitating surgical omentectomy.

Conclusions:

• Blind percutaneous Tenckhoff catheter insertion is a viable and cost-effective method for CAPD access.
• The technique is associated with a low rate of major complications.
• Potential complications like omental wrapping require careful consideration and management.