Original Article

J Minim Invasive Surg 2008; 11(2): 145-150

Published online December 15, 2008

© The Korean Society of Endo-Laparoscopic & Robotic Surgery

지속성 외래 복막투석도관 삽입을 위한 복강경 수술과 개복 수술의 비교

장태영ㆍ강진모1ㆍ박양진ㆍ윤익진2ㆍ민승기ㆍ하종원ㆍ김상준

서울대학교 의과대학 외과학교실, 1가천의대길병원 외과, 2건국대학교병원 외과

A Comparison of the Laparoscopic Method versus the Traditional Open Method for Continuous Ambulatory Peritoneal Dialysis Catheter Insertion

Tae Young Chang, M.D., Jin Mo Kang, M.D.1, Yang Jin Park, M.D., Ik Jin Yoon, M.D.2, Seung-Kee Min, M.D., Jongwon Ha, M.D., Sang Joon Kim, M.D.

Department of Surgery, Seoul National University Hospital, Seoul, 1Gachon University Gill Hospital, Incheon, 2Konkuk University Medical Center, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: Continuous ambulatory peritoneal dialysis (CAPD) is an important method of renal replacement therapy for patients with chronic renal failure. A significant number of complications and catheter failures in CAPD are due to mechanical problems and peritonitis. Secure, correct positioning of the catheter is important to minimize the risk. The purpose of this study is to compare the clinical outcomes of two different CAPD catheter insertion techniques, that is, the laparoscopic method versus the traditional open technique. Methods: We reviewed a total of 96 consecutive cases of CAPD catheter insertion that were performed at Seoul National University Hospital from January 2004 to December 2005 (laparoscopic: 52, open: 44). The data was retrospectively collected using the medical records to determine the clinical results and the catheter-related complication. Results: There was no case of catheter obstruction in the laparoscopic group, but there was 1 case in the open group. There were 6 cases of catheter migration in each group. There were 12 cases of peritonitis in the laparoscopic group and 7 cases in the open group. There were 7 cases of exit site infection in the laparoscopic group and 5 cases in the open group. There were 8 cases of incisional hernia in the laparoscopic group and 2 cases in open group. There were 2 cases of peritosol leakage in the laparoscopic group and 1 case in the open group. The incidence of complication was not statistically different between the groups. Conclusion: The laparoscopic technique showed a similar mechanical complication rate compared to the open technique. Incisional hernia developed more frequently in the laparoscopic group, and incisional hernia requires more careful closure technique.

Keywords Continuous ambulatory peritoneal dialysis, Peritoneal dialysis, Laparoscopy

Article

Original Article

J Minim Invasive Surg 2008; 11(2): 145-150

Published online December 15, 2008

Copyright © The Korean Society of Endo-Laparoscopic & Robotic Surgery.

지속성 외래 복막투석도관 삽입을 위한 복강경 수술과 개복 수술의 비교

장태영ㆍ강진모1ㆍ박양진ㆍ윤익진2ㆍ민승기ㆍ하종원ㆍ김상준

서울대학교 의과대학 외과학교실, 1가천의대길병원 외과, 2건국대학교병원 외과

A Comparison of the Laparoscopic Method versus the Traditional Open Method for Continuous Ambulatory Peritoneal Dialysis Catheter Insertion

Tae Young Chang, M.D., Jin Mo Kang, M.D.1, Yang Jin Park, M.D., Ik Jin Yoon, M.D.2, Seung-Kee Min, M.D., Jongwon Ha, M.D., Sang Joon Kim, M.D.

Department of Surgery, Seoul National University Hospital, Seoul, 1Gachon University Gill Hospital, Incheon, 2Konkuk University Medical Center, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: Continuous ambulatory peritoneal dialysis (CAPD) is an important method of renal replacement therapy for patients with chronic renal failure. A significant number of complications and catheter failures in CAPD are due to mechanical problems and peritonitis. Secure, correct positioning of the catheter is important to minimize the risk. The purpose of this study is to compare the clinical outcomes of two different CAPD catheter insertion techniques, that is, the laparoscopic method versus the traditional open technique. Methods: We reviewed a total of 96 consecutive cases of CAPD catheter insertion that were performed at Seoul National University Hospital from January 2004 to December 2005 (laparoscopic: 52, open: 44). The data was retrospectively collected using the medical records to determine the clinical results and the catheter-related complication. Results: There was no case of catheter obstruction in the laparoscopic group, but there was 1 case in the open group. There were 6 cases of catheter migration in each group. There were 12 cases of peritonitis in the laparoscopic group and 7 cases in the open group. There were 7 cases of exit site infection in the laparoscopic group and 5 cases in the open group. There were 8 cases of incisional hernia in the laparoscopic group and 2 cases in open group. There were 2 cases of peritosol leakage in the laparoscopic group and 1 case in the open group. The incidence of complication was not statistically different between the groups. Conclusion: The laparoscopic technique showed a similar mechanical complication rate compared to the open technique. Incisional hernia developed more frequently in the laparoscopic group, and incisional hernia requires more careful closure technique.

Keywords: Continuous ambulatory peritoneal dialysis, Peritoneal dialysis, Laparoscopy

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