Peritoneal dialysis catheter placement in the right lower quadrant is associated with a lower risk of catheter tip...

The aim of this study was to investigate the effect of a modified technique for peritoneal dialysis catheter placement in the right lower quadrant with respect to catheter tip migration.

This retrospective study included 237 patients with end-stage renal disease who underwent implantation of a two-cuff straight-end swan-neck catheter for peritoneal dialysis. Ninety-eight patients received conventional catheter placement in the left quadrant (beside the umbilicus 12-13 cm above the pubic symphysis) with catheter exit site on the left, and 139 patients received modified catheter placement in the right lower quadrant (beside the umbilicus 6-7 cm above the pubic symphysis) with catheter exit site on the right. Dialysate inflow time, dialysate outflow time, ultrafiltration volume, infection, hemorrhage, intestinal obstruction, and catheter tip migration were recorded.

There were no significant differences in dialysate inflow time, dialysate outflow time, ultrafiltration volume, infection, hemorrhage, or intestinal obstruction between the conventional and modified groups. Catheter tip migration occurred in 19 (19.3%) of the 98 patients in the conventional group, and in 5 (3.6%) of the 139 patients in the modified group. The frequency of occurrence of catheter tip migration was significantly less in the modified group compared with the conventional group (p < 0.01). In addition, repositioning of the catheter occurred in all five patients with catheter tip migration in the modified group after conservative treatment, whereas 12 patients required surgical repositioning of the catheter in the conventional group.

The modified technique is superior to the conventional technique in reducing catheter tip migration. This technique can be widely performed in the clinic.