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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Laparoscopic salvage of malfunctioning Tenckhoff catheters
Journal of Laparoendoscopic and Advanced Surgical Techniques, Volume 17, No. 1, Year 2007
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Description
Purpose: Peritoneal dialysis is a practical and appropriate form of dialysis in developing countries, as patients can be trained to do this at home. The aim of this study was to assess the efficacy of laparoscopic techniques in managing malfunctioning Tencklioff catheters in a supraregional nephrology and transplant center. Materials and Methods: Between 2001 and 2004, 43 patients required Tenckhoff catheter insertion (20 males and 23 females). The average age was 8.9 years (range, 2-17 years). Four patients had their catheter tip sutured to the pelvic peritoneum and 11 underwent omentectomy at initial insertion. Laparoscopic salvage was performed using two or three 5-mm ports. If required, the tip of the catheter could be inspected and cleaned by delivering it through one of the port sites. The catheter was then replaced in the abdomen with the tip lying in the pelvis. Twenty patients (6 males and 14 females) required surgical correction for malfunctioning catheters. Eleven underwent a total of 13 laparoscopic salvage operations, and 9 patients had open replacement of catheters. Results: The causes of malfunction identified in the laparoscopic group were occlusion by fimbriae (n = 4) or omentum (n = 1), peritonitis (n = 4), and displacement of catheter (n = 4). In the open replacement group 2 patients had peritonitis, 1 had occlusion due to fimbriae, and 1 due to omentum. Five had no cause identified. Re-look laparotomy and diathermy hemostasis of fimbriae was required in one patient due to bleeding from fimbriae following laparoscopic retraction of fimbriae from the peritoneal dialysis catheter. Conclusion: Twenty of forty-three (46%) patients required Tenckhoff catheter salvage surgery. The laparoscopic approach enabled us to visualize the cause of malfunction and correct problems without reinsertion of a new catheter, as had been our previous practice. © Mary Ann Liebert, Inc.
Authors & Co-Authors
Numanoglu, Alp
South Africa, Cape Town
University of Cape Town
McCulloch, Mignon I.
South Africa, Cape Town
University of Cape Town
van der Pool, Anne Elisabeth Maria
South Africa, Cape Town
University of Cape Town
Millar, Allistair John Ward
South Africa, Cape Town
University of Cape Town
Rode, Heinz
South Africa, Cape Town
University of Cape Town
Statistics
Citations: 5
Authors: 5
Affiliations: 1
Identifiers
Doi:
10.1089/lap.2006.0542
ISSN:
10926429
e-ISSN:
15579034
Research Areas
Health System And Policy
Noncommunicable Diseases
Participants Gender
Female