The technique and outcome of peritoneal dialysis catheter revision

Tenchkhoff catheter malposition is a significant cause of technical failure in patients with peritoneal dialysis (PD). Many surgical revised techniques have been reported including wire manipulation and laparoscopy. The objective of the present study was to report the outcome of surgical revised technique for catheter malposition in patients with PD.

The data of one hundred and twenty three patients with peritoneal dialysis at the HRH Princess Maha Chakri Sirindhorn Medical Center were reviewed. The Tenchkhoff catheters were revised in ten patients who had delayed outflow drainage and failed with nonsurgical treatment. The outcome of catheter placement and revision were reported.

The longest catheter survival time in the authors' patient was 71 months. The Tenchkhoff catheters were revised successfully in ten patients. The positions of exit sites were not changed. The immediate postoperative complication was not found. The second revision of Tenchkhoff catheter was performed in three patients. Five patients died from other causes not related to the catheter malposition, one patient was referred to another hospital, and four patients had still undergone CAPD.

The authors catheter-revised technique is safe, simple, straightforward and no special instrument needed therefore it is suitable to be practiced in Thailand.