PDI
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Perit Dial Int 30(1): 56-62
2010
© 2010 International Society for Peritoneal Dialysis
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Google Scholar
Right arrow Articles by Yip, T.
Right arrow Articles by Lo, W. K.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Yip, T.
Right arrow Articles by Lo, W. K.

Clinical

A PROSPECTIVE RANDOMIZED STUDY COMPARING TENCKHOFF CATHETERS INSERTED USING THE TRIPLE INCISION METHOD WITH STANDARD SWAN NECK CATHETERS

Terence Yip1, Sing Leung Lui1, Kai Chung Tse1, Hong Xu2, Flora S.K. Ng1, Suk Wai Cheng1, Tak Mao Chan1, Kar Neng Lai1 and Wai Kei Lo1

Dr. Lee Iu Cheung Memorial Renal Research Centre,1 Tung Wah Hospital, Department of Medicine, The University of Hong Kong, Hong Kong SAR; Nephrology Department,2 Peking Union Medical College Hospital, Beijing, China

Correspondence to: T. Yip, Department of Medicine, Tung Wah Hospital, 12 Po Yan Street, Hong Kong, China. terenceyip{at}netvigator.com

{diamondsuit} Background and Objective: The downward directed exit of the swan neck catheter may decrease the risk of exit-site infection (ESI). The percentage of migrations of the swan neck catheter seems to be less than the conventional Tenckhoff catheter and the swan neck catheter is more expensive and cannot be manipulated by guidewire technique if tip migration occurs. In this study, the conventional Tenckhoff catheter was used. The straight tunnel was converted to an arcuate one using the triple incision method, resulting in a downward directed exit. The arcuate tunnel was created by passing the catheter through an additional incision located between the paramedian incision and the exit site. We compared the infective and mechanical complications of the Tenckhoff catheter with a downward exit, implanted using the triple incision method, with the swan neck catheter.

{diamondsuit} Patients and Methods: 101 new peritoneal dialysis patients were prospectively randomized to receive either the Tenckhoff catheter with a downward exit, implanted using the triple incision method, or the swan neck catheter. Each patient was followed up for 24 months. 50 patients were in the triple incision method group (TIMG) and 51 were in the swan neck catheter group (SNCG).

{diamondsuit} Results: Over a mean period of 18.9 ± 8.0 months of follow-up, ESI occurred in 35 patients (70%) in TIMG and 37 patients (72.5%) in SNCG (p = 0.83). The ESI rates were 0.71 and 1.0 episodes/catheter-year in TIMG and SNCG respectively (p = 0.21). The peritonitis rates were similar in the 2 groups (0.64 episodes/year in TIMG and 0.68 episodes/year in SNCG, p = 0.47). More patients in TIMG had tip migration [15 patients (30%) in TIMG vs 10 patients (19.6%) in SNCG] but the difference was not statistically significant. Repositioning of the catheter by guidewire manipulation was successful in patients in TIMG but not in SNCG. Overall catheter survival at 12 and 24 months was 95% and 83% in TIMG and 93% and 79% in SNCG respectively (p = 0.72).

{diamondsuit} Conclusion: By using the conventional Tenckhoff catheter with a downward exit created using the triple incision method, high catheter survival rates with infective and mechanical complication rates similar to those of the swan neck catheter can be achieved. The triple incision method has the additional advantages of lower cost and the catheter can be manipulated by guidewire technique if tip migration occurs.

KEY WORDS: Dialysis catheter insertion; Tenckhoff catheter insertion; triple incision method; catheter implantation.

Received 20 October 2008; accepted 23 April 2009.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Multimed Inc. logo
Copyright © 2010 by Multimed Inc.