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The "Half-Perc" technique using a simple modified metal trocar for peritoneal dialysis catheter placement: results of a 3-year follow-up of 280 patients and a literature review

  • Nephrology - Original Paper
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Abstract

Purpose

There is an ongoing debate about the ideal technique for peritoneal dialysis (PD) catheter insertion in patients with end-stage renal disease (ESRD). A half-percutaneous ("Half-Perc") technique shares some of the advantages of both percutaneous technique and traditional open surgery. This retrospective study aimed to evaluate the clinical feasibility, safety, and effects of the "Half-Perc" technique for PD catheter placement, and to compare the clinical outcomes of the "Half-Perc" technique with various imaging-assisted percutaneous techniques from the current literature.

Methods

We included 280 consecutive patients with ESRD who underwent the "Half-Perc" insertion of the first PD catheter between September 2016 and September 2019. We recorded baseline characteristics, operative parameters, catheter-related complications, catheter survival, and the reason behind PD cessation.

Results

We included 174 men and 106 women, with a mean age of 50.4 years (range, 11–85 years). The mean operative time was 28.8 min (range, 15–38 min) and technical success rate was observed in 278 patients (99.3%). There were 28 episodes (10%) of mechanical complications with initial catheters occurring during the follow-up. Catheter malfunctions were the most common mechanical complication and were observed in 15 patients. Peritonitis was the most frequent catheter-related complication, with 32 episodes of peritonitis observed in 29 (10.4%) patients. After a mean follow-up period of 15.4 months (range, 2–36 months), 235 patients (83.9%) survived with their initial PD catheter by the end of the study. Of the 280 patients analyzed, 35 patients (12.5%) ceased PD at some stage during follow-up. The most common reason for PD cessation was kidney transplantation (18 patients (6.4%)), followed by death (9 patients (3.2%)) and switch to hemodialysis (HD) (7 patients (2.5%)), and recovery of renal failure (1 patient (0.4%)).

Conclusion

The "Half-Perc" technique, including a modified metal trocar, is a simple, safe, and effective method for PD catheter placement that can be used for patients with ESRD.

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Author notes

  1. Difei Zhang and Rongrong Li contributes equally to this work and considered to be first authors.

Authors and Affiliations

  1. The Second Clinical College of Guangzhou University of Chinese Medicine, No. 111 Dade Road, Guangzhou, 510405, China

    Difei Zhang, Rongrong Li, Jingwen He & Fuhua Lu

  2. Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, No. 111 Dade Road, Guangzhou, 510120, China

    Difei Zhang, Yu Peng, Hui Liu, Xusheng Liu & Fuhua Lu

Authors
  1. Difei Zhang
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  2. Rongrong Li
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  4. Yu Peng
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  7. Fuhua Lu
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Correspondence to Yu Peng or Fuhua Lu.

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This manuscript has been reviewed and approved by all of the authors, and no results reported in this manuscript have been published elsewhere. All authors declare that there are no conflicts of interest.

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Zhang, D., Li, R., He, J. et al. The "Half-Perc" technique using a simple modified metal trocar for peritoneal dialysis catheter placement: results of a 3-year follow-up of 280 patients and a literature review. Int Urol Nephrol 54, 1741–1749 (2022). https://doi.org/10.1007/s11255-021-03028-w

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