Evidence - Peritoneal dialysis: Laparoscopic-assisted catheter insertion in CAPD

Comparison of “open surgery” and laparoscopic insertion technique

A prospective randomized clinical trial with 148 patients (72 with open surgery, 76 with laparoscopy) studied the complication rate and service life during a follow-up period of 3 years.

Early complications (all): open 33.3% < > lap. 13,2%

• Peritonitis 12.5% < > 2.6%
• Catheter malfunction 8.3% < > 7,9%
• Leakage 11.1% < > 1.3%
• Colon perforation none < > 1.3%
• Bladder perforation 1.4% < > none

Late complications (all): open 61.1% < > lap. 57.9%

• Infections 48.6% < > 48.7%
• Catheter malfunction 11.1% < > 7,9%
• Hernia 1.4% < > 1.3%
• Catheter failure 55.2% < > 32.8%

Catheter service life

• after 12 months: open 62% < > lap. 77.5%
• after 36 months: open 26% < > lap. 63%

Gadallah MF, Pervez A, el-Shahawy MA, Sorrells D, Zibari G, McDonald J, Work J. Peritoneoscopic versus surgical placement of peritoneal dialysis catheters: a prospective randomized study on outcome. Am J Kidney Dis. 1999 Jan; 33(1):118-22.

For ongoing trials see: www.isrctn.com

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