Laparoscopic peritoneal dialysis catheter placement is associated with decreased deep organ infection and reoperation

Chyi Chyi Chong, Tze Woei Tan, Kenneth Abreo, Marie E. Pahilan, Denis Rybin, Gheorghe Doros, Wayne W. Zhang, Alik Farber

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Introduction: The optimal method for placement of peritoneal dialysis catheters (PDC) is unclear. The objective of this study was to compare the outcomes of laparoscopic and open surgical placement of PDC. Materials and methods: Patients who underwent laparoscopic (LPD) and open (OPD) surgical placement of PDC between 2007 and 2011 were identified from the American College of Surgeons National Surgical Quality Initiative Project (NSQIP) dataset using current procedural terminology (CPT) and international classification of diseases 9th revision (ICD-9) codes. Perioperative outcomes were compared using Fisher's exact test for categorical variables, Student's t-test and Gamma regression were used for continuous variables. Catheter function was not reported in the dataset. Results: There were 1,560 PDC procedures in our study and most were performed laparoscopically (89%). 83% of these procedures were performed by general surgeons, mostly, with the patients under general anesthesia (95%). OPD was associated with a higher rate of perioperative deep organ infection (3.5% vs. 1.1%, p = 0.02) and need for reoperation (10.4% vs. 5.0%, p = 0.007). Operative time was, however, significantly longer with LPD (53.3 vs. 45.5 minutes, p < 0.001). In multivariate analysis, OPD was independently associated with increased risk of perioperative deep organ infection (odds ratio (OR) 3.7,95%, Confidence Interval (CI) 1.3 - 10.2, p = 0.01) and reoperation (OR 2.3, 95% CI 1.3 - 4.1, p = 0.005). Conclusions: Laparoscopic PDC placement is more commonly performed and is associated with a lower risk of perioperative deep organ infection and reoperation than the open surgical approach. When possible, laparoscopic PDC placement might be preferable over open surgical placement.

Original languageEnglish (US)
Pages (from-to)161-166
Number of pages6
JournalClinical Nephrology
Volume83
Issue number3
DOIs
StatePublished - 2015
Externally publishedYes

Keywords

  • Laparoscopic peritoneal dialysis catheter placement
  • Open peritoneal dialysis catheter placement
  • PD catheter
  • Peritoneal dialysis catheter
  • peritoneal dialysis

ASJC Scopus subject areas

  • Nephrology

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