Scientific Session 15 — SS15: Vascular/Interventional - Vascular and Dialysis InterventionsWednesday, April 25, 2018
1147. Outcomes of Imaging guided placement versus laparoscopic placement of peritoneal dialysis catheters
Abdel Aal A, Mahmoud K*, Moawad S, Ertel N, Almehmi A. University of Alabama at Birmingham, Birmingham, Alabama
Address correspondence to A. Abdel Aal (firstname.lastname@example.org)
Objective: A variety of peritoneal dialysis catheter (PDC) placement techniques are available including laparoscopic placement by surgeons, and percutaneous placement by interventional radiologists. The aim of this study was to compare the 1-year outcomes of both techniques.
Materials and Methods:
We retrospectively reviewed the medical records of 240 patients who had their first peritoneal dialysis catheter placed between January 2005 and December 2015.We compared the outcomes of the catheters placed using fluoroscopic and ultrasound guidance (IR group, n = 50), with the catheters placed using laparoscopic technique (LAP group, n = 190).The primary endpoint was complication-free catheter survival at 365 days. Secondary endpoints were complication-free catheter survival at 90 days, overall catheter survival at 365 days, median days-to-first complication and median days-to-catheter removal. Differences between groups were assessed using chi square, Mann-Whitney U tests and Kaplan Meier methods.
The study included 240 patients (134 women, 56%), median age was 54.7 years (IQR, 41.3–64.3), and median BMI was 28.3 (IQR, 24.1–34.5). There was no significant difference in the baseline characteristics of both groups. In the IR group, the complication-free catheter survival at 90 and 365 days were 64% and 48%, compared to 70.5% (p = 0.37) and 53.4% (p = 0.49) respectively, in the LAP group. Catheter malfunction was significantly higher in the LAP group (30%) compared to the IR group (16%, p = 0.05). Catheter leak was significantly higher in the IR group (10%) compared to the LAP group (3.2%, p = 0.05). There was no statistically significant difference in the overall catheter survival at 365 days between the two groups.
Conclusion: The fluoroscopic and ultrasound guided placement of PDC offers a clinically effective alternative to laparoscopic placement with similar survival rates. The rate of catheter malfunction was higher in the LAP group, while the rate of catheter leak was higher in the IR group.