[Complications of Laparoscopic Versus Minimally Invasive Peritoneal Dialysis Catheter Installation]

Currently, the techniques for installing peritoneal dialysis catheters are divided into advanced laparoscopic (LAP) or minimally invasive (MMI) methods, which include percutaneous and mini-laparotomy approaches. International registries don't favor one technique or operator (surgeon or nephrologist) over the other.

To compare early and late complications of CPD installation via MMI by a nephrologist versus LAP.

This is a retrospective study of the patient database from the Hospital Clínico de la Universidad de Chile between January 2014 and August 2022, who underwent CPD installation. Early and late complications were evaluated, with a 30-day limit from the procedure. STATA 14 software was used, employing a p<0.05 for statistical significance.

A total of 264 patients were identified, with a mean age of 53.4 years. 50% were women, and 26.9% were diabetic. In 61.7% of CPDs, the MMI approach was used. The overall complication rate was 43.9%, with early complications accounting for 27.6% of these. The most frequent early complication was repositioning (7.6%), with 80% occurring in the MMI group. For late complications, peritonitis was the most frequent (44%). There was no mortality associated with the procedure. Comparing MMI and LAP groups, no statistically significant differences were found in early or late complications (p= 0.21 and p= 0.11, respectively). Analysis of the repositioning subgroup also showed no superiority of either technique (MMI: 9.8% vs LAP 4%; p= 0.096).

The LAP approach is not superior to MMI performed by a nephrologist in terms of early or late complications or overall mortality. However, a trend towards a lower repositioning rate was observed in the LAP group.