A comparative study on catheter survival between percutaneous and open surgical placement of peritoneal dialysis catheters

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Abstract Title *

A comparative study on catheter survival between percutaneous and open surgical placement of peritoneal dialysis catheters

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Co-author 1

Fumiaki Nogaki nogaki-f@water.ocn.ne.jp Shimada General Medical Center Nehrology Shimada Japan *

Co-author 2

Shintaro Kubo ks1d9013@gmail.com Shimada General Medical Center Nehrology Shimada Japan -

Co-author 3

Ryo Hatano Rhatano0403@gmail.com Shimada General Medical Center Nehrology Shimada Japan -

Co-author 4

Masato Kamiya m14037mk@jichi.ac.jp Shimada General Medical Center Nehrology Shimada Japan -

Co-author 5

Daiki Masuda shougiya@gmail.com Shimada General Medical Center Nehrology Shimada Japan -

Co-author 6

Taro Hirai taro_hirai@outlook.jp Hirai Clinic Nephrology Yaizu Japan -

Co-author 7

Noriyuki Suzuki suzukin@vanilla.ocn.ne.jp Tokyo Metropolitan Institute for Geriatrics and Gerontology Nephrology Tokyo Japan -

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Percutaneous peritoneal dialysis (PD) catheter placement is a minimally invasive procedure and is particularly suitable for elderly patients. Although several studies have reported no significant difference in catheter survival between percutaneous and open surgical placement, most PD catheters in Japan are still placed by open surgery, and comparative data remain limited. Since 2016, our department has performed percutaneous PD catheter placement using the Seldinger technique. This study aimed to evaluate the outcomes of our percutaneous technique by comparing it with open surgical placement, which has been performed by the urology department since 2012.

Methods

We included patients undergoing their first PD initiation. In the percutaneous group, PD was started after at least one week following catheter insertion. Catheter survival was defined as the period from insertion to catheter removal due to catheter-related complications. Catheter survival rates were analyzed using the Kaplan–Meier method for 76 patients in the percutaneous group and 36 patients in the open surgery group.

Results

No patients required catheter removal due to catheter malfunction. However, two patients in the percutaneous group underwent laparoscopic catheter repositioning because radiological intervention failed to correct catheter dysfunction. In both groups, all cases that required catheter removal were attributable to refractory peritonitis or tunnel infection. The one-year catheter survival rates were 93.9% in the percutaneous group and 94.1% in the open surgery group, while the two-year survival rates were 84.9% and 84.3%, respectively, with no significant difference between the two groups.

Conclusion

The percutaneous PD catheter placement performed in our department showed catheter survival comparable to that of open surgical placement, indicating that it is an equally effective insertion technique.

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