COMPLICATIONS AFTER TENCKHOFF CATHETER INSERTION: A SINGLE-CENTRE EXPERIENCE USING MULTIPLE OPERATORS OVER FOUR YEARS

• Published in: Peritoneal dialysis international Vol. 30; no. 5; pp. 509 - 512
• Main Authors: Liu, Wen Jiun, Hooi, Lai Seong
• Format: Journal Article
• Language: English
• Published: United States Multimed Inc 01.09.2010
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bacterial Infections - epidemiology; Bacterial Infections - etiology; Bacterial Infections - microbiology; Catheterization - adverse effects; Catheterization - methods; Catheters, Indwelling - adverse effects; Cohort Studies; Equipment Design; Equipment Failure; Female; Follow-Up Studies; Foreign-Body Migration - epidemiology; Foreign-Body Migration - etiology; Foreign-Body Migration - physiopathology; Humans; Incidence; Kidney Failure, Chronic - diagnosis; Kidney Failure, Chronic - therapy; Male; Middle Aged; Peritoneal Dialysis, Continuous Ambulatory - adverse effects; Peritoneal Dialysis, Continuous Ambulatory - instrumentation; Peritonitis - epidemiology; Peritonitis - etiology; Peritonitis - microbiology; Retrospective Studies; Risk Assessment; Time Factors; Young Adult
• ISSN: 0896-8608; 1718-4304
• DOI: 10.3747/pdi.2009.00083

To analyze the complications after Tenckhoff catheter insertion among patients with renal failure needing dialysis. ♢ The open, paramedian approach is the commonest technique to insert the 62-cm coiled double-cuffed Tenckhoff peritoneal catheter. All patients with catheters inserted between January 2004 and November 2007 were retrospectively analyzed for demographics and followed for up to 1 month for complications. We excluded patients whose catheters had been anchored to the bladder wall and who underwent concurrent omentectomy or readjustment without removal of a malfunctioning catheter (n = 7). Intravenous cloxacillin was the standard preoperative antibiotic prophylaxis. ♢ Over the 4-year study period, 384 catheters were inserted under local anesthetic into 319 patients [201 women (62.8%); mean age: 49.4 ± 16.7 years (range: 13 - 89 years); 167 (52.2%) with diabetes; 303 (95%) with end-stage renal disease] by 22 different operators. All Tenckhoff catheters were inserted by the general surgical (n = 223) or urology (n = 161) team. There were 29 cases (7.6%) of catheter migration, 22 (5.7%) of catheter obstruction without migration, 24 (6.3%) of exit-site infection, 12 (3.1%) of leak from the main incision, 14 (3.6%) of culture-proven wound infection, 11 (2.9%) post-insertion peritonitis, and 1 (0.3%) hemoperitoneum. No deaths were attributed to surgical mishap. ♢ The most common complication was catheter migration. The paramedian insertion technique was safe, with low complication rates.