Outcomes after peritoneal dialysis catheter placement

BackgroundThe purpose of this study was to review surgical outcomes after elective placement of peritoneal dialysis (PD) catheters in children with end-stage renal disease.MethodsChildren with PD catheters placed between February 2002 and July 2014 were retrospectively reviewed. Outcomes were catheter life, late (> 30 days post-op) complications (catheter malfunction, catheter malposition, infection), and re-operation rates. Comparison groups included laparoscopic versus open placement, age < 2, and weight < 10 kg. Univariate and multivariate analysis were performed.ResultsOne hundred sixteen patients had 173 catheters placed (122 open, 51 laparoscopic) with an average patient age of 9.7 ± 6.3 years. Mean catheter life was similar in the laparoscopic and open groups (581 ± 539 days versus 574 ± 487 days, p = 0.938). The late complication rate was higher for open procedures (57% versus 37%, p = 0.013). Children age < 2 or weight < 10 kg had higher re-operation rates (64% versus 42%, p = 0.014 and 73% versus 40%, p = 0.001, respectively). Adjusted for age and weight, open technique remained a risk factor for late complications (OR 2.44, 95% CI 1.20-4.95) but not re-operation.DiscussionLaparoscopic placement appears to reduce the rate of late complications in children who require PD dialysis catheters. Children < 2 years age or < 10 kg remain at risk for complications regardless of technique.