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EXPERIENCE WITH 150 CONSECUTIVE PERMANENT PERITONEAL CATHETERS IN PATIENTS ON CAPD

From the Transplantation^* , Surgery^** , Urology^*** and Nephrology^**** Departments. Instituto Nacional de la Nutricion, "Salvador Zubiran". Vasco de Quiroga #15, Tlalpan 14000, Mexico, D.F.

From 1978 to 1984, 150 consecutive CAPD catheters have been implanted in our institution. Early (first-week) and late (up to 44 months) follow-up is presented with special attention to possible surgical related complications.

A paramedian incision and an original antileakage technique were used in 95% of the catheters. With this combination, hernia and leakage rates are very low (0.7%()). With the patient-training program, described here, and the installation of the catheter in the outpat ient department, peritonitis during the first week dropped from 20% to 0%() (p < 0.05). Previous abdominal operations significantly increase early failures (p < 0.05). Skin exit-site infections were not seen in our patients. The most frequent long-term complications were catheter colonization, i.e. recurrent peritonitis with the same organism, and repeated peritonitis episodes leading to obstruction. The one year actuarial catheter survival is 40% .This paper discusses factors responsible for as well as possible improvement of this low figure.

KEY WORDS: CAPD; catheters; surgery; complications; peritonitis.

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