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Minilaparotomy for malfunctioning peritoneal dialysis catheter by nephrologists: experiences at two centers

机译:MiniLaparotomy对肾病学腹膜透析导管发生故障:两个中心的经验

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摘要

Abstract Catheter malfunction is one of the most important complications of peritoneal dialysis (PD). We have performed minilaparotomy for catheter repair by nephrologists. This study aimed to evaluate the effectiveness and safety of the surgery. The surgery was performed 11 times on 10 PD patients with catheter malfunction (3 man, 7 women; mean age 54.3 ± 14.6 years; 4 diabetes, 3 glomerulonephritis, 3 other) at two hospitals. All patients had inflow and/or outflow obstruction. One patient had inserted the PD catheter using conventional surgical technique, and the remaining nine patients had used Moncrief-Popovich technique. Seven patients with catheters embedded using the Moncrief-Popovich technique showed catheter occlusion at the time of externalization. The remaining three patients experienced catheter obstruction 6.0 ± 2.9 months after commencing PD. The cause of obstruction was fibrin in six patients, wrapping by fimbriae of the fallopian tube in two patients, omentum wrapping in two patients. One patient had no blockage in the catheter. Operative time was 97 ± 46 min, and no intraoperative complications were observed. PD was interrupted for 5.9 ± 3.0 days and was resumed without leakage in all patients. However, catheter malfunction recurred in one patient 3 months after the surgery. The mean hospital stay was 22.4 ± 14.7 days. Minilaparotomy by nephrologists is a safety and suitable for the management of catheter malfunction. In addition, it is necessary to always consider the possibility that the catheter has been occluded at the time of externalization in the Moncrief-Popovich technique.
机译:摘要导管故障是腹膜透析最重要的并发症之一(PD)。我们对肾病学家进行了导管修复的MiniLaparotomy。本研究旨在评估手术的有效性和安全性。在10名PD患者上进行手术11次导管故障(3人,7名女性;平均54.3±14.6岁; 4糖尿病,3个糖尿病,3个肾小球肾炎,3个其他)在两家医院。所有患者均具有流入和/或流出障碍。一名患者使用常规手术技术插入了PD导管,剩余的九个患者使用了MONCRIFIE-POPOVICH技术。使用MONCRIFIF-POPOVICH技术嵌入的导管患者在外部化时显示导管闭塞。其余三名患者经历了导管梗阻6.0±2.9个月后开始PD。梗阻的原因是六位患者的纤维蛋白,两名患者Fimbriae的Fimbriae包装,两名患者的全膜包裹。一名患者在导管中没有堵塞。手术时间为97±46分钟,没有观察到术中并发症。 PD被中断为5.9±3.0天,所有患者都没有泄漏恢复。然而,在手术后3个月后,在一名患者中重复导管发生故障。平均医院住宿是22.4±14.7天。 Minilaparotomy受到肾病学家的安全性,适合管理导管故障。此外,有必要始终考虑在MONCRIFF-POPOVICH技术的外化时堵塞导管的可能性。

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