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Clinical |
Internal Medicine,1 East-West Neo Medical Center of Kyung Hee University; Internal Medicine2 and Radiology,3 Kyung Hee University, Seoul, Republic of Korea
Correspondence to: T.W. Lee, Department of Internal Medicine, College of Medicine, Kyung Hee University, #1, Hoekidong, Dongdaemun-Ku, Seoul 130-701, Korea. wonkid{at}chol.com
Objective: Despite percutaneous fluoroscopy ensuring
appropriate placement of peritoneal dialysis (PD) catheters, the efficacy of
this method is not well known. Therefore, we evaluated our long-term
experience with fluoroscopy-assisted placement of PD catheters.
Patients and Methods: We retrospectively reviewed 134
PD catheters in 114 PD patients that were treated in the PD center of a
university-based hospital. We evaluated complications related to PD catheters,
causes for catheter removal, and catheter survival. We used the multivariate
Cox proportional hazard model to identify independent factors related to PD
catheter survival.
Results: Early complications related to insertion
included 1 case of pericatheter bleeding; there were no placement failures.
Early complications occurred in 8.5% of patients. Most late complications were
migration and leakage, which occurred in 10.4% and 9.7% of patients
respectively. The most common cause for catheter removal was intractable and
recurrent peritonitis. The 12- and 24-month survival rates of the catheters
were 80.0% and 74.9%. The most significant prognostic factor of percutaneous
fluoroscopy-assisted PD catheter survival was late leakage (p <
0.01).
Conclusions: In addition to the advantages of
simplicity, minimal invasiveness, and relative safety, the survival rate of PD
catheters placed using the percutaneous fluoroscopy-assisted method was
comparable to that of more invasive methods. Percutaneous fluoroscopy-assisted
placement of PD catheters should be considered when available, and may be
preferred to other placement methods.
KEY WORDS: Methods of catheter replacement; percutaneous fluoroscopically guided placement; catheter.
Received 10 June 2007; accepted 23 October 2007.
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