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Importance of the creation of a short musculofascial tunnel in peritoneal dialysis catheter placement

World Journal of Clinical Cases 2022年第4期10卷 1182-1189页

作者： Chih-Yuan Lee Meng-Kun Tsai Yi-Ting Chen Yu-Jun Zhan Min-Ling Wang Chien-Chia Chen Department of Surgery National Taiwan University HospitalTaipei 100Taiwan Division of General Surgery Department of SurgeryNational Taiwan University Biomedical Park HospitalNational Taiwan University Hospital Hsinchu BranchHsinchu 302Taiwan Renal Division Department of Internal MedicineNational Taiwan University HospitalTaipei 100Taiwan Department of Integrated Diagnostics&Therapeutics National Taiwan University HosptialTaipei 100Taiwan Department of Nursing National Taiwan University HospitalTaipei 100Taiwan Division of General Surgery Department of SurgeryNational Taiwan University HospitalTaipei 100Taiwan

BACKGROUND Peritoneal dialysis(PD)catheter migration impedes the efficacy of ***,several techniques involving additional sutures or incisions have been proposed to maintain catheter position in the *** To evaluate the efficacy of creating a short musculofascial tunnel beneath the anterior sheath of the rectus abdominis during PD catheter *** Patients who underwent PD catheter implantation between 2015 and 2019 were included in this retrospective *** patients were divided into two groups based on the procedure performed:Patients who underwent catheter implantation without a musculofascial tunnel before 2017 and those who underwent the procedure with a tunnel after *** recorded patient character istics and catheter complications over a two-year follow-up *** addition,postoperative plain abdominal radiographs were reviewed to determine the catheter angle in the event of *** The no-tunnel and tunnel groups included 115 and 107 patients,*** to the no-tunnel group,the tunnel group showed lesser catheter angle deviation toward the pelvis(15.51±11.30 vs 25.00±23.08,P=0.0002)immediately after the operation,and a smaller range of migration within 2 years postoperatively(13.48±10.71 vs 44.34±41.29,Pcatheter dysfunction due to migration were observed in the no-tunnel group,and none occurred in the tunnel *** was no difference in the two-year catheter function survival rate between the two groups(88.90%vs 84.79%,P=0.3799).CONCLUSION The musculofascial tunnel helps maintain catheter position in the pelvis and reduces migration,thus preventing catheter dysfunction.

关键词： catheter migration Peritoneal dialysis tenckhoff catheter implantation Renal replacement

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