Low-site versus traditional peritoneal dialysis catheterization: A meta-analysis

Area of Science:

• Nephrology
• Surgical Procedures
• Medical Devices

Background:

• Peritoneal dialysis (PD) is a crucial renal replacement therapy.
• Catheter placement is a key step in PD, with potential complications.
• Comparing surgical techniques for PD catheter insertion is vital for patient outcomes.

Purpose of the Study:

• To compare the complication rates of low-site PD catheter placement versus traditional open surgery.
• To evaluate the efficacy and safety of different PD catheter insertion methods.

Main Methods:

• A systematic literature search was conducted across major databases (PubMed, Embase, Cochrane Library, CNKI, Wanfang) up to September 2019.
• A meta-analysis included seven studies comparing low-site PD catheter placement with traditional open surgery.
• Data analysis utilized Review Manager Version 5.3.

Main Results:

• The meta-analysis included 504 patients in the low-site group and 325 in the traditional open surgery group.
• Low-site PD catheter placement demonstrated significantly lower rates of catheter displacement (OR 0.11) and non-catheter displacement dysfunction (OR 0.11) compared to traditional surgery.
• No significant differences were observed between the two methods regarding bleeding, PD fluid leakage, hypogastralgia, peritonitis, or exit-site/tunnel infections.

Conclusions:

• Low-site PD catheter placement is associated with reduced risks of catheter displacement and dysfunction.
• This technique does not elevate the risk of other common complications, including bleeding, infection, and pain.
• Further large-scale, multicenter randomized controlled trials are recommended to validate these findings.