Journal Home
Search for

Volume 159, Issue 1, Pages 489-496 (March 2010)


View previous. 14 of 35 View next.

Prospective Randomized Study for Comparison of Open Surgery with Laparoscopic-Assisted Placement of Tenckhoff Peritoneal Dialysis Catheter—A Single Center Experience and Literature Review

Shyh-Chuan Jwo, M.D.Corresponding Author Informationemail address, Kuo-Su Chen, M.D., Chin-Chan Lee, M.D., Huang-Yang Chen, M.D.

Received 13 June 2006 published online 09 October 2008.

Background

The ideal method for catheter placement in patients undergoing peritoneal dialysis remains debatable. This prospective study intends to clarify whether laparoscopic assisted percutaneous puncture is superior to open surgery.

Materials and Methods

From 2002 to 2006, 77 patients receiving first catheter placement were enrolled and randomized to either an open group of 40 patients or a laparoscopic group of 37 patients. Patient characteristics, operation-related data, procedural complications, and clinical outcome were compared by using the statistical software SPSS ver. 11.5 (SPSS, Chicago, IL).

Results

Laparoscopy had a longer operative time (68.32 ± 31.90 versus 46.68 ± 15.99 min; P < 0.001), shorter wound length (1.69 ± 0.46 versus 2.34 ± 0.84 cm; P < 0.001), and higher costs (P < 0.001) compared with open surgery. Laparoscopy tended to have a higher incidence of pericannular bleeding (21.6% versus 7.5%) and a lower rate of early catheter migration (2.7% versus 15.0%), but its early/late/overall complication rate did not statistically differ. No surgical mortality occurred. Rate and cause of overall mortality or catheter dropout did not statistically differ. Catheter longevity was equivalent in both groups.

Conclusions

Laparoscopic assisted percutaneous puncture exhibited no superiority to open surgery. As a matter of fact, open surgery's shorter operative time and reduced equipment requirement can increase cost-effectiveness. Therefore, conventional open surgery is recommended for most patients with primary catheter placement.

 Division of General Surgery, Chang Gung Memorial Hospital, Keelung, and Chang Gung University, Tao-Yuan, Taiwan, ROC

 Division of Nephrology, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC

 Division of General Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan, Republic of China

Corresponding Author InformationTo whom correspondence and reprint requests should be addressed at Division of General Surgery, Chang Gung Memorial Hospital, 222 Mai-Chin Road, 204 Keelung, Taiwan, ROC.

PII: S0022-4804(08)00589-1

doi:10.1016/j.jss.2008.09.008


View previous. 14 of 35 View next.