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Clinical |
Mirza Koochak Khan Hospital,1 Amir-Alam Hospital,2 Medical Sciences/University of Tehran,3 Tehran, Iran
Correspondence to: M. Abouzari, No.17, Alaei Alley, Ard-e-Iran Street, Shahr-e-Rey, Tehran, Iran. abouzari.m{at}gmail.com
Background: Laparoscopic techniques for placement of
peritoneal dialysis catheters are becoming increasingly popular. In this
paper, we report the results of one-port laparoscopic placement of Tenckhoff
catheters in 79 patients in our center.
Method: Videoscopic monitoring was performed via a port
inserted in the left upper quadrant and the catheter was placed via a
pull-apart sheath through an incision near the umbilicus. The tip and the deep
cuff of the catheter were placed into the true pelvis (on the urinary bladder)
and into the rectus sheath respectively. A subcutaneous tunnel was created and
a point midway on the umbilico-crestal line was selected as the exit site of
the catheter. Catheters were capped for 2 weeks before initiation of
peritoneal dialysis. Mean duration of the operation was 25 minutes.
Results: Four patients died during the follow-up
period, all due to other medical problems, and 4 patients underwent renal
transplantation. During a 48-month follow-up, catheter-related complications
were catheter migration (1.3%; month 1), dialysate leakage (1.3%; month 1),
portsite hernia (3.8%; after 6 months), exit-site infection (2.5%; months 1
and 9), and bacterial peritonitis (2.5%; after 6 months). Catheter survival
was 97.2% in our series.
Conclusion: We obtained a low complication rate and a
high catheter survival rate with this one-port laparoscopic technique.
KEY WORDS: Laparoscopy; Tenckhoff catheter.
Received 5 August 2007; accepted 24 March 2008.
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