Catheter-related infections continue to be the most common complication of CPD, and the most frequent cause of catheter removal. Available evidence supports the superiority of double-cuff catheters and a downward-facing tunnel for preventing peritonitis in children. The Swan-neck double-cuff catheter seems best suited to achieving those objectives, while still reducing the problems of external cuff extrusion and catheter migration. Clearly further pediatric experience with that catheter is desirable. Analysis of the literature confirms that excellent catheter survival and a reduced rate of infectious complications can be achieved with a variety of catheter designs and implantation techniques. The most crucial aspect of catheter success and survival appears to be the commitment and expertise of the team involved in catheter insertion and postoperative catheter management.

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