Comparison of Laparoscopic and Conventional Methods for Continuous Ambulatory Peritoneal Dialysis Catheter Insertion in Terms of Complications*

OBJECTIVE: There are various methods for inserting a peritoneal dialysis catheter. Conventional and laparoscopic methods are superior to each other in many different aspects. In this study, both methods were compared with each other in terms of complications.

MATERIAL and METHODS: Data from 54 patients with end stage renal diseases who were operated for peritoneal dialysis catheter insertion in between 2006 and 2008 at the Department of General Surgery, Faculty of Medicine and University of Akdeniz were analyzed retrospectively. The laparoscopic method was used for 37 patients and the conventional method was used for 17 patients for peritoneal dialysis catheter insertion. While the catheter was placed into pelvis with the aid of a guide wire in the conventional group (CG), it was placed into the pelvis by a camera through a tunnel, formed at preperitoneal field in laparoscopic group (LG).

RESULTS: Demographic characteristics of two groups were similar. Median follow up duration was 137 days (range 4 - 678). Functionality rate in one-year for catheters were 87 % in LG and 77 % in CG groups (log rank test p=0.341). Dialysate leakage rates were 19% and 29%, catheter infections rates were 11% and 12% in LG and CG, respectively (p>0.05). However for peritonitis complication, there were significant differences between two groups, 14% and 41% in LG and CG, respectively (p<0.05).

CONCLUSION: The complications of laparoscopic and conventional surgery methods were compared to place a peritoneal dialysis catheter in the present study. It was observed that among all the compared complications, only the frequency of peritonitis was lower in patients who were operated laparoscopically.