J Korean Surg Soc.  2006 Mar;70(3):170-174.

Continuous Ambulatory Peritoneal Dialysis (CAPD) Catheter Insertion Using the Fluoroscopy and Minimal Skin Incision

• Kim KH
• Park SY
• Oh SM
• Lee MR
• Kim SH
• Park KJ
• Kim MC
• Kim YH
• Jung GJ
• Park CM
• An WS
• Kim SE
• Kim KH

Abstract

PURPOSE: Continuous ambulatory peritoneal dialysis (CAPD) is an important method of performing renal replacement therapy in patients with chronic renal failure. A significant number of complications and catheter failures in CAPD are due to mechanical pro-blems and peritonitis. We describe our experience with CAPD with using fluoroscopy and a minimal incision technique to reduce complications.
METHODS
We reviewed 57 CAPD patients at Dong-A University Medical Center from June 2004 to March 2005. All the procedures were standardized and performed by a single surgeon with using a flexible guide wire under aseptic fluoroscopic control through a minimal incision. Antibiotic treatment was done for three days after the surgery.
RESULTS
The patients consisted of 30 males and 27 females. The common reasons for CAPD insertion were diabetic nephropathy (25 patients) and hypertension (9 patients). The mean operation time was 52.2+/-15.8 minutes. All the initial procedures were carried out under local anesthesia. Four of the patients needed their catheter repositioned during their postoperative course, which was done under local anesthesia in three cases and under spinal anesthesia in one case. Catheter malfunction occurred in 4 patients, and peritonitis developed in 8 patients (for wound related peritonitis in 1 patient and for catheter related peritonitis in 7 patients).
CONCLUSION
Making a minimum incision and catheter insertion under fluoroscopic control for CAPD is a safe and highly effective method to reduce the incidence of catheter related complications. Furthermore, strict patient education is crucial for optimum catheter care, which is closely associated with development of peritonitis in CAPD patients.

Keyword

Continuous ambulatory peritoneal dialysis; Chronic renal failure; Fluoroscopy; Minimal skin incision

MeSH Terms

Academic Medical Centers
Anesthesia, Local
Anesthesia, Spinal
Catheters*
Diabetic Nephropathies
Female
Fluoroscopy*
Humans
Hypertension
Incidence
Kidney Failure, Chronic
Male
Patient Education as Topic
Peritoneal Dialysis, Continuous Ambulatory*
Peritonitis
Renal Replacement Therapy
Skin*
Wounds and Injuries