Comparative Study of Outcomes Following Laparoscopic Versus Open Peritoneal Dialysis Catheter Insertion at a Tertiary Care Centre

Abstract

Objective:Continuous ambulatory peritoneal dialysis is a common treatment mode in patients with end-stage renal disease. Various insertion techniques of continuous ambulatory peritoneal dialysis catheters have been described in the literature, including percutaneous, open and laparoscopic techniques, with no consensus about the preferred operative technique.Materials and Methods:Between August 2016 and March 2018, 50 patients undergoing catheter insertion were randomised to insertion by either the open technique or laparoscopy. The demographic, preoperative and postoperative profiles of these patients were recorded and patients were followed up for six weeks postoperatively. The Pearson chi-square test was used to compare the results with historical controls. Fisher’s Exact test was used to assess the incidence of surgical complications. The significance level was set at 0.05.Results:A comparison between the two groups indicated that the only significant difference was in postoperative pain on postoperative evening, lower in the laparoscopic group and statistically significant (p<0.05). There was no statistically significant difference in catheter tip migration, catheter exit-site infection, catheter-associated peritonitis or catheter functional status between the two techniques.Conclusion:The laparoscopic technique does not provide any additional advantage than the open technique in patients undergoing continuous ambulatory peritoneal dialysis catheter placement.

Keywords

• continuous ambulatory peritoneal dialysis catheter
• comparison
• open surgery
• laparoscopic