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Laparoscopic Versus Open Insertion of Peritoneal Dialysis Catheters in Pediatric Patients: A Systematic Review and

Marcella Mota Constante1, Letizia Corbi2, Maria Luísa Maffioletti3

  • 1Department of General Surgery, Hospital Municipal José Lucas Filho, Minas Gerais, Brazil.

Journal of Pediatric Surgery
|August 28, 2025
PubMed

Insights

Laparoscopic Tenckhoff catheter placement in pediatric patients significantly reduces reoperation and peritonitis risks compared to open surgery. This minimally invasive approach may offer improved outcomes for end-stage renal disease management.

Area of Science:

  • Nephrology
  • Pediatric Surgery
  • Minimally Invasive Surgery

Background:

  • Peritoneal dialysis (PD) is a preferred treatment for pediatric end-stage renal disease, enhancing quality of life.
  • Tenckhoff catheter placement is crucial for PD, but complications remain a concern.
  • Laparoscopic techniques offer improved visualization and potential for better catheter longevity.

Purpose of the Study:

  • To compare the effectiveness and safety of laparoscopic versus open surgical Tenckhoff catheter placement in pediatric patients.
  • Evaluate outcomes including reoperation, peritonitis, and catheter-related complications.

Main Methods:

  • Systematic review and meta-analysis adhering to PRISMA guidelines.
  • Searched PubMed, EMBASE, and Cochrane databases through May 2025.
  • Included nine observational studies (659 pediatric patients) comparing laparoscopic and open PD catheter placement.

Main Results:

  • Laparoscopic placement significantly reduced reoperation (OR=0.28) and peritonitis (OR=0.21) risks.
  • Pooled analysis favored the laparoscopic approach for overall outcomes (OR=0.55).
  • No significant differences in catheter migration, obstruction, or infection rates were found.

Conclusions:

  • Laparoscopic Tenckhoff catheter insertion is associated with lower reoperation and peritonitis risks.
  • The laparoscopic approach may be considered the preferred method for pediatric PD catheter placement.
  • Further randomized studies are needed to confirm these findings.
Abstract

Keywords:
Laparoscopic PD catheterOpen PD catheterPediatricPeritoneal dialysisTenckhoffrenal failurerenal transplant

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