A Prospective Follow-up Observational Study of Laparoscopic Insertion of CAPD Catheters as a Modality of Management of End-stage Renal Disease (CKD – Stage V)
Taskeen M Sikora, Ravi V Patel, Satish J Deshmane, Shrinivas Ambike
Citation Information :
Sikora TM, Patel RV, Deshmane SJ, Ambike S. A Prospective Follow-up Observational Study of Laparoscopic Insertion of CAPD Catheters as a Modality of Management of End-stage Renal Disease (CKD – Stage V). World J Lap Surg 2023; 16 (3):133-136.
Aim: To study benefits and complications of continuous ambulatory peritoneal dialysis (CAPD) catheter placement laparoscopically with suture fixation technique.
Patients and methods: A total of 41 cases of end-stage renal disease [chronic kidney disease (CKD) – Stage V] were admitted in Jehangir Hospital, Pune. Patients were evaluated, after explaining the procedure, the risks and benefits they were prepared for the procedure. Patients were assessed for complications and mortality as well as the reason for discontinuation of CAPD.
Results: Of 41 cases studied, 39 (95.2%) had CAPD started, in 1 (2.4%) CAPD was not started and 1 (2.4%) did not have CAPD inserted. Of 41 cases studied, 28 (68.3%) had CAPD continued successfully for 2 years. Of 41 cases studied, 4 (9.8%) had catheter outflow block, 4 (9.8%) had peritonitis, 6 (14.6%) had ultrafiltration failure, 3 (7.3%) had exit site leak, 1 (2.4%) had catheter malposition/kinking, none had incisional hernia, 2 (4.9%) had hemoperitoneum. A total of 10 patients (24.4%) had catheter removed at the end of the study.
Conclusion: Approximately, 68% of patients, that is 28 patients out of 41 continued CAPD for 2 years after the catheter was inserted laparoscopically. Out of the 41 patients, 20 patients developed minor complications. Out of the 20 patients, 10 patients developed major complications and needed the catheter to be removed. Mortality was 9.8%, out of which two patients died of sepsis and 2 died of comorbidity-related complications.
Clinical significance: Laparoscopic CAPD catheter placement is an effective method and has good success rate with less complications and better patient tolerability.
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