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Laparoscopic versus open peritoneal dialysis catheter placement

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Abstract

Background

Laparoscopy revolutionized many General Surgery procedures by decreasing hospital stay, minimizing recovery time, and reducing wound infection rates. This study evaluates the potential benefits of laparoscopic approach to peritoneal dialysis catheter (PDC) placement.

Methods

The American College of Surgeons National Surgical Quality Improvement Program database was queried for laparoscopic and open PDC placement. We evaluated patient demographics, comorbidities, operative time, length of stay (LOS), and postoperative outcomes. Univariate comparison and multivariate logistic regression analysis (MVA) adjusting for confounding factors including age, body mass index (BMI), comorbidities, and preoperative conditions were performed.

Results

A total of 3134 patients undergoing PDC placement were recorded in the NSQIP database between 2005 and 2012, including 2412 laparoscopic cases (LPDC) (77 %) and 722 open (OPDC). Overall, the majority of cases were performed by General Surgeons (81 %) with most of the remainder completed by Vascular Surgeons (16.8 %). Patients undergoing LPDC versus OPDC demonstrated no significant difference in gender (54 vs. 56 % males, p = 0.4), smoking history (8.5 ± 18.3 vs. 7.2 ± 16.9 pack years, p = 0.06), diabetes (42 vs. 40 %, p = 0.4), COPD (4.6 vs. 5 %, p = 0.63), or preoperative dialysis requirement (72 vs. 73 %, p = 0.6), but they were younger (57.2 ± 14.8 vs. 60.5 ± 15.9 years, p = 0.05) and had a higher BMI (29.3 vs. 29 kg/m2, p = 0.04). In univariate analysis of LPDC versus OPDC, overall wound complications (1.6 vs. 2.9 %, p = 0.02), deep surgical site infections (0.12 vs. 0.83 %, p < 0.006), minor complications (3.8 vs. 6.5 %, p < 0.05), major complications (4.3 vs. 6.9 %, p < 0.05), and LOS (1.8 ± 11.9 vs. 4.4 ± 10 days, p < 0.0001) favored the LPDC approach, but only operative time (57.6 ± 4.6 vs. 71.8 ± 5.3, p < 0.001) remained significant in MVA after controlling for confounding factors. Both LPDC and OPDC had equivalently low rates of catheter failure (0.21 vs. 0.14 %, p = 0.7).

Conclusion

Using univariate analysis, there appears to be a benefit from LPDC placement. However, after controlling for confounding variables, the techniques appear to have equal outcomes. Surgeons should perform a LPDC or OPDC according to the approach with which they are most familiar. However, continued adoption, dispersal, and refinement of the laparoscopic approach may further optimize patient outcomes.

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References

  1. Collins AJ, Foley RN, Chavers B, Gilbertson D, Herzog C, Ishani A, Johansen K, Kasiske BL, Kutner N, Liu J, St Peter W, Guo H, Hu Y, Kats A, Li S, Li S, Maloney J, Roberts T, Skeans M, Snyder J, Solid C, Thompson B, Weinhandl E, Xiong H, Yusuf A, Zaun D, Arko C, Chen SC, Daniels F, Ebben J, Frazier E, Johnson R, Sheets D, Wang X, Forrest B, Berrini D, Constantini E, Everson S, Eggers P, Agodoa L (2014) US renal data system 2013 annual data report. Am J Kidney Dis 63(1 Suppl):A7. doi:10.1053/j.ajkd.2013.11.001

    Article  PubMed  Google Scholar 

  2. Jain AK, Blake P, Cordy P, Garg AX (2012) Global trends in rates of peritoneal dialysis. J Am Soc Nephrol: JASN 23(3):533–544. doi:10.1681/asn.2011060607

    Article  PubMed Central  PubMed  Google Scholar 

  3. Asif A (2005) Peritoneal dialysis catheter insertion. Minerva Chir 60(5):417–428

    CAS  PubMed  Google Scholar 

  4. Gajjar AH, Rhoden DH, Kathuria P, Kaul R, Udupa AD, Jennings WC (2007) Peritoneal dialysis catheters: laparoscopic versus traditional placement techniques and outcomes. Am J Surg 194(6):872–875. doi:10.1016/j.amjsurg.2007.08.038 (discussion 875-876)

    Article  PubMed  Google Scholar 

  5. Cope C, Kramer MS (1974) Letter: laparoscopic retrieval of dialysis catheter. Ann Intern Med 81(1):121

    Article  CAS  PubMed  Google Scholar 

  6. Crabtree JH, Fishman A (1996) Laparoscopic epiplopexy of the greater omentum and epiploic appendices in the salvaging of dysfunctional peritoneal dialysis catheters. Surg Laparosc Endosc 6(3):176–180

    Article  CAS  PubMed  Google Scholar 

  7. Amerling R, Maele DV, Spivak H, Lo AY, White P, Beaton H, Rudick J (1997) Laparoscopic salvage of malfunctioning peritoneal catheters. Surg Endosc 11(3):249–252

    Article  CAS  PubMed  Google Scholar 

  8. Barone GW, Johnson DD, Webb JW (1998) A practical approach to laparoscopic surgery for malfunctioning peritoneal dialysis catheters. J Laparoendosc Adv Surg Tech A 8(1):19–23

    Article  CAS  PubMed  Google Scholar 

  9. Lee M, Donovan JF (2002) Laparoscopic omentectomy for salvage of peritoneal dialysis catheters. J Endourol/Endourol Soc 16(4):241–244. doi:10.1089/089277902753752214

    Article  Google Scholar 

  10. Santarelli S, Zeiler M, Marinelli R, Monteburini T, Federico A, Ceraudo E (2006) Videolaparoscopy as rescue therapy and placement of peritoneal dialysis catheters: a thirty-two case single centre experience. Nephrol Dial Transplant 21(5):1348–1354. doi:10.1093/ndt/gfk041

    Article  PubMed  Google Scholar 

  11. Yilmazlar T, Kirdak T, Bilgin S, Yavuz M, Yurtkuran M (2006) Laparoscopic findings of peritoneal dialysis catheter malfunction and management outcomes. Perit Dial Int: J Int Soc Perit Dial 26(3):374–379

    Google Scholar 

  12. Caliskan K, Nursal TZ, Tarim AM, Noyan T, Moray G, Haberal M (2007) The adequacy of laparoscopy for continuous ambulatory peritoneal dialysis procedures. Transpl Proc 39(5):1359–1361. doi:10.1016/j.transproceed.2007.02.088

    Article  CAS  Google Scholar 

  13. Numanoglu A, McCulloch MI, Van Der Pool A, Millar AJ, Rode H (2007) Laparoscopic salvage of malfunctioning Tenckhoff catheters. J Laparoendosc Adv Surg Tech A 17(1):128–130. doi:10.1089/lap.2006.0542

    Article  PubMed  Google Scholar 

  14. Aasvang EK, Hansen JB, Kehlet H (2008) Can preoperative electrical nociceptive stimulation predict acute pain after groin herniotomy? J Pain 9(10):940–944. doi:10.1016/j.jpain.2008.05.015

    Article  PubMed  Google Scholar 

  15. Goh YH (2008) Omental folding: a novel laparoscopic technique for salvaging peritoneal dialysis catheters. Perit Dial Int: J Int Soc Perit Dial 28(6):626–631

    Google Scholar 

  16. Brandt CP, Franceschi D (1994) Laparoscopic placement of peritoneal dialysis catheters in patients who have undergone prior abdominal operations. J Am Coll Surg 178(5):515–516

    CAS  PubMed  Google Scholar 

  17. Nijhuis PH, Smulders JF, Jakimowicz JJ (1996) Laparoscopic introduction of a continuous ambulatory peritoneal dialysis (CAPD) catheter by a two-puncture technique. Surg Endosc 10(6):676–679

    Article  CAS  PubMed  Google Scholar 

  18. Watson DI, Paterson D, Bannister K (1996) Secure placement of peritoneal dialysis catheters using a laparoscopic technique. Surg Laparosc Endosc 6(1):35–37

    Article  CAS  PubMed  Google Scholar 

  19. Lu CT, Watson DI, Elias TJ, Faull RJ, Clarkson AR, Bannister KM (2003) Laparoscopic placement of peritoneal dialysis catheters: 7 years experience. ANZ J Surg 73(3):109–111

    Article  PubMed  Google Scholar 

  20. Schmidt SC, Pohle C, Langrehr JM, Schumacher G, Jacob D, Neuhaus P (2007) Laparoscopic-assisted placement of peritoneal dialysis catheters: implantation technique and results. J Laparoendosc Adv Surg Tech A 17(5):596–599. doi:10.1089/lap.2006.0162

    Article  PubMed  Google Scholar 

  21. Crabtree JH, Burchette RJ (2009) Effective use of laparoscopy for long-term peritoneal dialysis access. Am J Surg 198(1):135–141. doi:10.1016/j.amjsurg.2008.10.019

    Article  PubMed  Google Scholar 

  22. Attaluri V, Lebeis C, Brethauer S, Rosenblatt S (2010) Advanced laparoscopic techniques significantly improve function of peritoneal dialysis catheters. J Am Coll Surg 211(6):699–704. doi:10.1016/j.jamcollsurg.2010.08.010

    Article  PubMed  Google Scholar 

  23. Ma JJ, Chen XY, Zang L, Mao ZH, Wang ML, Lu AG, Li JW, Feng B, Dong F, Zheng MH (2013) Laparoscopic peritoneal dialysis catheter implantation with an intra-abdominal fixation technique: a report of 53 cases. Surg Laparosc Endosc Percutan Tech 23(6):513–517. doi:10.1097/SLE.0b013e31828fa6ae

    Article  CAS  PubMed  Google Scholar 

  24. Crabtree JH, Fishman A (1999) Videolaparoscopic implantation of long-term peritoneal dialysis catheters. Surg Endosc 13(2):186–190

    Article  CAS  PubMed  Google Scholar 

  25. Sauerland S, Jaschinski T, Neugebauer EA (2010) Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev 10:CD001546. doi:10.1002/14651858.CD001546.pub3

    PubMed  Google Scholar 

  26. Perissat J, Collet D, Belliard R, Desplantez J, Magne E (1992) Laparoscopic cholecystectomy: the state of the art. A report on 700 consecutive cases. World J Surg 16(6):1074–1082

    Article  CAS  PubMed  Google Scholar 

  27. Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW (1992) Laparoscopic cholecystectomy. The new ‘gold standard’? Arch Surg 127(8):917–921 (discussion 921-913)

    Article  CAS  PubMed  Google Scholar 

  28. Khuri SF, Daley J, Henderson W, Barbour G, Lowry P, Irvin G, Gibbs J, Grover F, Hammermeister K, Stremple JF et al (1995) The National Veterans Administration Surgical Risk Study: risk adjustment for the comparative assessment of the quality of surgical care. J Am Coll Surg 180(5):519–531

    CAS  PubMed  Google Scholar 

  29. Khuri SF, Daley J, Henderson W, Hur K, Demakis J, Aust JB, Chong V, Fabri PJ, Gibbs JO, Grover F, Hammermeister K, Irvin G 3rd, McDonald G, Passaro E Jr, Phillips L, Scamman F, Spencer J, Stremple JF (1998) The Department of Veterans Affairs’ NSQIP: the first national, validated, outcome-based, risk-adjusted, and peer-controlled program for the measurement and enhancement of the quality of surgical care. National VA Surgical Quality Improvement Program. Ann Surg 228(4):491–507

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  30. Ross SW, Oommen B, Wormer BA, Walters AL, Matthews BD, Heniford BT, Augenstein VA (2015) National outcomes of laparoscopic Heller myotomy: operative complications and risk factors for adverse events. Surg Endosc. doi:10.1007/s00464-014-4054-0

    Google Scholar 

  31. Draganic B, James A, Booth M, Gani JS (1998) Comparative experience of a simple technique for laparoscopic chronic ambulatory peritoneal dialysis catheter placement. Aust N Z J Surg 68(10):735–739

    Article  CAS  PubMed  Google Scholar 

  32. Ogunc G, Tuncer M, Ogunc D, Yardimsever M, Ersoy F (2003) Laparoscopic omental fixation technique versus open surgical placement of peritoneal dialysis catheters. Surg Endosc 17(11):1749–1755. doi:10.1007/s00464-002-8586-3

    Article  CAS  PubMed  Google Scholar 

  33. Li JR, Chen WM, Yang CK, Shu KH, Ou YC, Ho HC, Cheng CL, Yang CR, Chiu KY (2011) A novel method of laparoscopy-assisted peritoneal dialysis catheter placement. Surg Laparosc Endosc Percutan Tech 21(2):106–110. doi:10.1097/SLE.0b013e31820af4ad

    Article  PubMed  Google Scholar 

  34. Gadallah MF, Pervez A, El-Shahawy MA, Sorrells D, Zibari G, McDonald J, Work J (1999) Peritoneoscopic versus surgical placement of peritoneal dialysis catheters: a prospective randomized study on outcome. Am J Kidney Dis 33(1):118–122

    Article  CAS  PubMed  Google Scholar 

  35. Jwo SC, Chen KS, Lee CC, Chen HY (2010) Prospective randomized study for comparison of open surgery with laparoscopic-assisted placement of Tenckhoff peritoneal dialysis catheter—a single center experience and literature review. J Surg Res 159(1):489–496. doi:10.1016/j.jss.2008.09.008

    Article  PubMed  Google Scholar 

  36. Tsimoyiannis EC, Siakas P, Glantzounis G, Toli C, Sferopoulos G, Pappas M, Manataki A (2000) Laparoscopic placement of the Tenckhoff catheter for peritoneal dialysis. Surg Laparosc Endosc Percutan Tech 10(4):218–221

    CAS  PubMed  Google Scholar 

  37. Wright MJ, Bel’eed K, Johnson BF, Eadington DW, Sellars L, Farr MJ (1999) Randomized prospective comparison of laparoscopic and open peritoneal dialysis catheter insertion. Perit Dial Int: J Int Soc Perit Dial 19(4):372–375

    CAS  Google Scholar 

  38. Crabtree JH, Fishman A (2005) A laparoscopic method for optimal peritoneal dialysis access. Am Surg 71(2):135–143

    PubMed  Google Scholar 

  39. Lund L, Jonler M (2007) Peritoneal dialysis catheter placement: Is laparoscopy an option? Int Urol Nephrol 39(2):625–628. doi:10.1007/s11255-007-9193-y

    Article  PubMed  Google Scholar 

  40. Strippoli GF, Tong A, Johnson D, Schena FP, Craig JC (2004) Catheter type, placement and insertion techniques for preventing peritonitis in peritoneal dialysis patients. Cochrane Database Syst Rev 4:CD004680. doi:10.1002/14651858.CD004680.pub2

    PubMed  Google Scholar 

  41. Hauch AT, Lundberg PW, Paramesh AS (2014) Laparoscopic techniques enable peritoneal dialysis in the difficult abdomen. JSLS: J Soc Laparoendosc Surg/Soc Laparoendosc Surg. doi:10.4293/jsls.2014.002334

    Google Scholar 

  42. Davis WT, Dageforde LA, Moore DE (2014) Laparoscopic versus open peritoneal dialysis catheter insertion cost analysis. J Surg Res 187(1):182–188. doi:10.1016/j.jss.2013.09.041

    Article  PubMed  Google Scholar 

  43. Haggerty SM, Roth S, Walsh D, Stefanidis D, Price R, Fanelli RD, Penner T, Richardson W (2015) Guidelines for laparoscopic peritoneal dialysis access surgery. http://www.sages.org/publications/guidelines/guidelines-laparoscopic-peritoneal-dialysis-access-surgery/. Accessed Jan 2015

  44. Crabtree JH (2014) SAGES guidelines for laparoscopic peritoneal dialysis access surgery. Surg Endosc 28(11):3013–3015. doi:10.1007/s00464-014-3812-3

    Article  PubMed  Google Scholar 

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Disclosures

Drs. Heniford and Augenstein have previously been awarded surgical research and education grants and honoraria from W.L. Gore and Associates, Ethicon, Novadaq, Bard/Davol, and LifeCell Inc. Dr. Kercher has received honoraria from Bard/Davol and Ethicon. Drs. Cox, Huntington, Blair, and Tanushree Prasad have no potential conflicts or disclosures relevant to this work.

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Authors and Affiliations

  1. Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Laparoscopic and Advanced Surgery Program, Carolinas Medical Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC, 28204, USA

    Tiffany C. Cox, Laurel J. Blair, Ciara R. Huntington, Tanushree Prasad, Kent W. Kercher, B. Todd Heniford & Vedra A. Augenstein

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  1. Tiffany C. Cox
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Correspondence to Tiffany C. Cox or Vedra A. Augenstein.

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Cox, T.C., Blair, L.J., Huntington, C.R. et al. Laparoscopic versus open peritoneal dialysis catheter placement. Surg Endosc 30, 899–905 (2016). https://doi.org/10.1007/s00464-015-4297-4

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