Different outcomes of peritoneal catheter percutaneous placement by nephrologists using a trocar versus the Seldinger technique: the experience of two Brazilian centers


Autoria(s): Ponce, Daniela; Banin, Vanessa B.; Bueloni, Tricya Nunes; Barretti, Pasqual; Caramori, Jacqueline; Balbi, André Luis
Contribuinte(s)

Universidade Estadual Paulista (UNESP)

Data(s)

18/03/2015

18/03/2015

01/10/2014

Resumo

A good catheter implantation technique is important to allow effective peritoneal access function and long-term technique survival. Studies regarding results obtained by nephrologists in comparison with different techniques have been limited. The aim of this study was to investigate the rate of early catheter-related complications and catheter survival in two Brazilian centers, according to two different percutaneous methods of catheter implantation performed by nephrologist team. Adult incident patients recruited from January 2006 to July 2013 having undergone first peritoneal dialysis (PD) catheter implantation were included in the analysis. Mechanical and infectious early complication rates were defined as time to the first event occurring up to 3 months. Four hundred and forty-five consecutive Tenckhoff catheters were implanted by nephrologist team percutaneously after antibiotic prophylaxis in an operating room: trocar was used in 349 (78.4 %) and Seldinger technique (ST) in 99 (21.6 %). The ST was significantly associated with a lower rate of leak (16.3 vs 3 %, p = 0.03) and outflow failure due to tip catheter migration (22.6 vs 10.1 %, p = 0.04), while early infectious complication rates were similar between the two groups (p = 0.59). Long-term catheter survival was higher in Seldinger group (log-rank, p = 0.031). By Cox multivariate analysis, adjusted for age, sex, and diabetes, the ST remained independently associated with better catheter survival [HR 0.681 (0.462-0.910), p = 0.04]. As conclusion, our experience showed better PD outcomes with the ST than trocar method of catheter implantation by nephrologist.

Formato

2029-2034

Identificador

http://dx.doi.org/10.1007/s11255-014-0738-6

International Urology And Nephrology. Dordrecht: Springer, v. 46, n. 10, p. 2029-2034, 2014.

0301-1623

http://hdl.handle.net/11449/116351

10.1007/s11255-014-0738-6

WOS:000342448800024

Idioma(s)

eng

Publicador

Springer

Relação

International Urology And Nephrology

Direitos

closedAccess

Palavras-Chave #Peritoneal dialysis #Access peritoneal #Percutaneous technique #Seldinger technique #Trocar method #Implant complications #Catheter survival
Tipo

info:eu-repo/semantics/article