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Surgical Endoscopy
Published in: Surgical Endoscopy 1/2024

21-11-2023 | Peritoneal Dialysis | SAGES/EAES Official Publication

SAGES peritoneal dialysis access guideline update 2023

Authors: Stephen P. Haggerty, Sunjay S. Kumar, Amelia T. Collings, Vamsi V. Alli, Emily Miraflor, Nader M. Hanna, Dimitrios I. Athanasiadis, David J. Morrell, Mohammed T. Ansari, Ahmed Abou-Setta, Danielle Walsh, Dimitrios Stefanidis, Bethany J. Slater

Published in: Surgical Endoscopy | Issue 1/2024

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Abstract

Background

Minimally invasive surgery has been used for both de novo insertion and salvage of peritoneal dialysis (PD) catheters. Advanced laparoscopic, basic laparoscopic, open, and image-guided techniques have evolved as the most popular techniques. The aim of this guideline was to develop evidence-based guidelines that support surgeons, patients, and other physicians in decisions on minimally invasive peritoneal dialysis access and the salvage of malfunctioning catheters in both adults and children.

Methods

A guidelines committee panel of the Society of American Gastrointestinal and Endoscopic Surgeons reviewed the literature since the prior guideline was published in 2014 and developed seven key questions in adults and four in children. After a systematic review of the literature, by the panel, evidence-based recommendations were formulated using the Grading of Recommendations Assessment, Development and Evaluation approach. Recommendations for future research were also proposed.

Results

After systematic review, data extraction, and evidence to decision meetings, the panel agreed on twelve recommendations for the peri-operative performance of laparoscopic peritoneal dialysis access surgery and management of catheter dysfunction.

Conclusions

In the adult population, conditional recommendations were made in favor of: staged hernia repair followed by PD catheter insertion over simultaneous and traditional start over urgent start of PD when medically possible. Furthermore, the panel suggested advanced laparoscopic insertion techniques rather than basic laparoscopic techniques or open insertion. Conditional recommendations were made for either advanced laparoscopic or image-guided percutaneous insertion and for either nonoperative or operative salvage. A recommendation could not be made regarding concomitant clean-contaminated surgery in adults. In the pediatric population, conditional recommendations were made for either traditional or urgent start of PD, concomitant clean or clean-contaminated surgery and PD catheter placement rather than staged, and advanced laparoscopic placement rather than basic or open insertion.
Appendix
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Metadata
Title
SAGES peritoneal dialysis access guideline update 2023
Authors
Stephen P. Haggerty
Sunjay S. Kumar
Amelia T. Collings
Vamsi V. Alli
Emily Miraflor
Nader M. Hanna
Dimitrios I. Athanasiadis
David J. Morrell
Mohammed T. Ansari
Ahmed Abou-Setta
Danielle Walsh
Dimitrios Stefanidis
Bethany J. Slater
Publication date
21-11-2023
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 1/2024
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-023-10550-8

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