Long-term outcomes of peritoneal dialysis catheters inserted by laparoscopic and percutaneous techniques in a single regional dialysis centre.

backgroundMinimally invasive insertion of catheters for peritoneal dialysis can be performed laparoscopically or percutaneously under image guidance. In Geelong (Victoria, Australia) both methods are used. Our aim was to analyse the outcomes of all catheters inserted by both laparoscopic and percutaneous techniques and compare them against published studies from tertiary referral centres.

methodsData were collected retrospectively on all patients who had their catheter inserted (since 2006) within the Geelong regional service. We compared the outcomes of percutaneous catheter insertion under image guidance (percutaneous group, n = 29) with the laparoscopic catheter placement technique (laparoscopic group, n = 61). Perioperative, follow-up and catheter outcome data were collected. There were no exclusion criteria. Analysis was performed using the unpaired student t-test and chi-squared test.

resultsNinety catheters were inserted between 2006 and 2017 in mostly male patients (63%) with a mean age of 60 ± 0.4 years. The most common aetiology of chronic kidney disease was diabetic nephropathy (34%). Percutaneous insertion required less operative time, shorter hospital stay and earlier initiation of peritoneal dialysis. In the longer term, percutaneous catheters were more likely to migrate and laparoscopic catheters were more durable but more often associated with peritonitis. Thirty-day complication rates did not differ between both groups. No Clavien-Dindo grade 3 or 4 complication was reported.

conclusionsLaparoscopic insertion of peritoneal dialysis catheters at our centre is performed safely and with patient outcomes comparable to published literature. Percutaneous insertion represents a safe and effective alternative based on the study findings.