Top

Pediatric Surgery International

Published in:

01-11-2018 | Original Article

Peritoneal dialysis catheter placement, outcomes and complications

Authors: Melanie B. LaPlant, Daniel A. Saltzman, Bradley J. Segura, Robert D. Acton, Brad A. Feltis, Donavon J. Hess

Published in: Pediatric Surgery International | Issue 11/2018

Abstract

Purpose

Peritoneal dialysis (PD) is a commonly used method for renal support in pediatric patients and can be associated with the risk of post-surgical complications. We evaluated method of placement of PD catheters with regard to post-surgical complications.

Methods

PD catheters placed at two institutions between 2005 and 2017 were reviewed. Complication rates were evaluated based on method of placement, delayed usage, omentectomy, and patient age using Fisher’s exact test, two-sided, with significance set at 0.05. Factors influencing complication were evaluated with multivariate logistic regression and Kaplan–Meier survival analysis.

Results

There were 130 patients with 157 catheters placed, ranging in age from 1 day to 23 years. There was no significant difference in complication rate by method of placement or delayed usage. Infants were significantly more likely to experience leakage (21% vs 8%, p 0.036) and hernias (15% vs 5%, p 0.030). Patients that underwent an omentectomy were less likely to require a catheter replacement (7% vs 27%, p 0.004), and the catheters had a significantly higher survival rate (p 0.009). We found that laparoscopic intervention resulted in catheter salvage. Lateral exit sites may be a risk factor for catheter migration in some patients.

Conclusions

Omentectomy is associated with longer PD catheter survival. Laparoscopic salvage of dysfunctional catheters may be a valuable adjunct in management.

Washburn KK, Currier H, Salter KJ, Brandt ML (2004) Surgical technique for peritoneal dialysis catheter placement in the pediatric patient: a North American Survey. Adv Perit Dial 20:218–221PubMed

Ustyol L, Peker E, Demir N, Agengin K, Tuncer O (2016) The use of acute peritoneal dialysis in critically Ill newborns. Med Sci Monit 22:1421–1426. https://doi.org/10.12659/MSM.898271 CrossRefPubMedPubMedCentral

Mattioli G, Castagnetti M, Verrina E, Trivelli A, Torre M, Jasonni V et al (2007) Laparoscopic-assisted peritoneal dialysis catheter implantation in pediatric patients. Pediatr Urol 69:1185–1189. https://doi.org/10.1016/j.urology.2006.12.033 CrossRef

Lane JC, Warady BA, Feneberg R, Majkowski NL, Watson AR, Fischbach M et al (2010) Relapsing peritonitis in children who undergo chronic peritoneal dialysis: a prospective study of the international pediatric peritonitis registry. Clin J Am Soc Nephrol 5:1041–1046. https://doi.org/10.2215/CJN.05150709 CrossRefPubMedPubMedCentral

Yavascan O, Anil M, Kara OD, Bal A, Akcan N, Senturk S (2011) The Comparison of exit-site care with normal saline and povidone–iodine in preventing exit-site infection and peritonitis in children on chronic peritoneal dialysis treatment. Saudi J Kidney Dis Transpl 22:931–934PubMed

Bakkaloglu S (2009) Prevention of peritonitis in children: emerging concepts. Perit Dial Int 29:S186–S189PubMed

Carpenter JL, Fallon SC, Swartz SJ, Minifee PK, Cass DL, Nuchtern JG et al (2016) Outcomes after peritoneal dialysis catheter placement. J Pediatr Surg 51:730–733. https://doi.org/10.1016/j.jpedsurg.2016.02.011 CrossRefPubMed

Cribbs RK, Greenbaum LA, Heiss KF (2010) Risk factors for early peritoneal dialysis catheter failure in children. J Pediatr Surg 45:585–589. https://doi.org/10.1016/j.jpedsurg.2009.06.019 CrossRefPubMed

Macchini F, Valade ÆA (2006) Chronic peritoneal dialysis in children: catheter related complications. A single centre experience. Pediatr S 22:524–528. https://doi.org/10.1007/s00383-006-1685-9 CrossRef

10.

Ladd AP, Breckler FD, Novotny NM (2011) Impact of primary omentectomy on longevity of peritoneal dialysis catheters in children. AJS 201:401–405. https://doi.org/10.1016/j.amjsurg.2010.08.022 CrossRef

11.

Phan J, Stanford S, Zaritsky JJ, Deugarte DA (2013) Risk factors for morbidity and mortality in pediatric patients with peritoneal dialysis catheters. J Pediatr Surg 48:197–202. https://doi.org/10.1016/j.jpedsurg.2012.10.035 CrossRefPubMed

12.

Numanoglu A, Rasche L, Roth MA, McCulloch MI, Rode H (2008) Laparoscopic insertion with tip suturing, omentectomy, and ovariopexy improves lifespan of peritoneal dialysis catheters in children. J Laparoendosc Adv Surg Tech 18:302–305. https://doi.org/10.1089/lap.2007.0100 CrossRef

13.

Radtke J, Schild R, Reismann M, Ridwelski R, Kempf C, Nashan B et al (2017) Obstruction of peritoneal dialysis catheter is associated with catheter type and independent of omentectomy: a comparative data analysis from a transplant surgical and a pediatric surgical department. J Pediatr Surg. https://doi.org/10.1016/j.jpedsurg.2017.06.028 CrossRefPubMed

14.

White CT, Gowrishankar M, Feber J, Yiu V, Association C (2006) Clinical practice guidelines for pediatric peritoneal dialysis. Pediatr Nephrol 21:1059–1066. https://doi.org/10.1007/s00467-006-0099-1 CrossRefPubMed

15.

Warady BA, Bakkaloglu S, Newland J, Cantwell M, Verrina E, Neu A et al (2012) Consensus guidelines for the prevention and treatment of catheter-related infections and peritonitis in pediatric patients receiving peritoneal dialysis: 2012 update. Perit Dial Int 32:S32–S86. https://doi.org/10.3747/pdi.2011.00091 CrossRefPubMedPubMedCentral

16.

Rahim KA, Seidel K, Mcdonald RA (2004) Risk factors for catheter-related complications in pediatric peritoneal dialysis. Pediatr Nephrol 19:1021–1028. https://doi.org/10.1007/s00467-004-1520-2 CrossRefPubMed

17.

Beanes SR, Kling KM, Fonkalsrud EW, Torres M, Salusky IB, Quinones-baldrich WJ et al (2000) Surgical aspects of dialysis in newborns and infants weighing less than 10 kg. J Pediatr Surg 35:1543–1548. https://doi.org/10.1053/jpsu.2000.18303 CrossRefPubMed

Title: Peritoneal dialysis catheter placement, outcomes and complications
Authors: Melanie B. LaPlant
Daniel A. Saltzman
Bradley J. Segura
Robert D. Acton
Brad A. Feltis
Donavon J. Hess
Publication date: 01-11-2018
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Surgery International / Issue 11/2018
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-018-4342-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Peritoneal dialysis catheter placement, outcomes and complications

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 11/2018

Contaminated or dirty wound operations and methicillin-resistant Staphylococcus aureus (MRSA) colonization during hospitalization may be risk factors for surgical site infection in neonatal surgical patients

Advances in understanding the association between Down syndrome and Hirschsprung disease (DS–HSCR)

Underestimation of genital lichen sclerosus incidence in boys with phimosis: results from a systematic review

Controversies in extracorporeal membrane oxygenation (ECMO) utilization and congenital diaphragmatic hernia (CDH) repair using a Delphi approach: from the American Pediatric Surgical Association Critical Care Committee (APSA-CCC)

Risk factors for short-term recurrent intussusception and reduction failure after ultrasound-guided saline enema

Analysis of water sports injuries admitted to a pediatric trauma center: a 13 year experience