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Pull technique versus open surgical removal of the catheter for peritoneal dialysis: a retrospective cohort study

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Abstract

Background

The open surgical technique (OST) is the main modality for peritoneal dialysis (PD) catheter removal; however, the pull technique (PT) is emerging as a minimally invasive alternative. At present, the safety and relative equivalence of PT and OST are unclear.

Methods

In this retrospective study, we reviewed the medical records of consecutive patients who underwent PD catheter removal via PT or OST at the Xinyang Central Hospital from April 2015 to October 2019. Complication-free survival (CFS) and surgical outcomes 365 days after PD catheter removal were evaluated and compared between groups.

Results

The PD catheter was removed in 89 patients. The final sample of 80 patients was selected based on eligibility for inclusion and exclusion criteria. Ten patients experienced complications (PT group, n = 2; OST group, n = 8), including death (n = 6), dialysate leak (n = 3), and incisional dehiscence (n = 1). Epidemiological and preoperative clinical characteristics were similar in all patients. Kaplan–Meier plots for CFS revealed significant differences in prognostic outcomes between the groups. Multivariate analysis revealed that CFS was similar in both groups (with OST as a reference; hazard ratio, 0.21; 95% confidence interval [CI], 0.03–1.27; P = 0.09). We observed significant differences in the operative time, blood loss, operative pain score, and anesthetic use between the groups (all P < 0.001). The length and cost of hospitalization were similar in both the groups.

Conclusions

PT is superior to OST in terms of blood loss, anesthetic use, operative pain score, and operating time without sacrificing safety and survival benefits.

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Acknowledgements

We thank Jie Liu, PhD (Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital) for his helpful review and comments regarding the manuscript.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Author notes

  1. Qi Ding, Bo Zhang, Min Liu, Xiaoyu Li and Lili Zuo have contributed equally to this work.

Authors and Affiliations

  1. Department of Nephrology, Xinyang Central Hospital, Xinyang, 464000, China

    Qi Ding, Bo Zhang, Min Liu, Xiaoyu Li & Lili Zuo

Authors
  1. Qi Ding
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  2. Bo Zhang
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  3. Min Liu
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  4. Xiaoyu Li
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Corresponding author

Correspondence to Qi Ding.

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Conflict of interest

The authors have declared that no conflict of interest exists.

Human rights

This study was approved by the ethics committee of the Xinyang Central Hospital, under number: 20210401.

Informed consent

The participants provided their written informed consent to participate in it at the time of enrollment. The study was conducted according to good clinical practices and the Declaration of Helsinki and its Trial Registration number is ChiCTR-2100046128.

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Ding, Q., Zhang, B., Liu, M. et al. Pull technique versus open surgical removal of the catheter for peritoneal dialysis: a retrospective cohort study. Clin Exp Nephrol 26, 827–834 (2022). https://doi.org/10.1007/s10157-022-02222-z

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  • DOI: https://doi.org/10.1007/s10157-022-02222-z

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