A Novel Technique for Correcting Peritoneal Dialysis Catheter Malposition and Blockage

Methods To investigate the safety and clinical significance of the method described in this study, we focused on 16 peritoneal dialysis patients with peritoneal dialysis (PD) catheter malposition and blockage in whom nonsurgical reposition was ineffective, who received a local incision about 5 cm below hypogastrium PD catheter insertions under local anesthesia. Tissues were separated layer by layer, 1-cm incisions were performed on the peritoneum vertically and conventionally, and then the PD catheters were pulled. Adherent mesentery was separated and the PD catheters were freed and removed sufficiently. PD catheters were introduced into the Dow cavity using large introducing forceps, were loop-ligated and fixed using 3# silk thread, and then the ligation line was sutured to the peritoneum. The tissues were managed layer by layer and the skin was sutured. All patients were followed up for half a year. Results Sixteen cases of refractory PD catheter malposition and blockage were managed successfully, with an operative incision of 3 cm and an operation time of 40±13 minutes. The localized anesthesia was well tolerated, and there were five cases in which lidocaine at 5 mg was added during the operation; postoperative pain was slight and only three patients used analgesics at night. All patients were treated with coagulation hemostasis, and there was no transfusion. No malposition, leakage or blockage was found at follow-up at more than six months. Conclusion It is safe, simple, inexpensive and associated with fewer complications to correct refractory PD catheter malposition and blockage by loop ligature and fixation through a minilaparotomy of inserted hypogastrium PD catheters promptly.