Purpose: Continuous ambulatory peritoneal dialysis (CAPD) is an important method of renal replacement therapy for patients with chronic renal failure. A significant number of complications and catheter failures in CAPD are due to mechanical problems and peritonitis. Secure, correct positioning of the catheter is important to minimize the risk. The purpose of this study is to compare the clinical outcomes of two different CAPD catheter insertion techniques, that is, the laparoscopic method versus the traditional open technique. Methods: We reviewed a total of 96 consecutive cases of CAPD catheter insertion that were performed at Seoul National University Hospital from January 2004 to December 2005 (laparoscopic: 52, open: 44). The data was retrospectively collected using the medical records to determine the clinical results and the catheter-related complication. Results: There was no case of catheter obstruction in the laparoscopic group, but there was 1 case in the open group. There were 6 cases of catheter migration in each group. There were 12 cases of peritonitis in the laparoscopic group and 7 cases in the open group. There were 7 cases of exit site infection in the laparoscopic group and 5 cases in the open group. There were 8 cases of incisional hernia in the laparoscopic group and 2 cases in open group. There were 2 cases of peritosol leakage in the laparoscopic group and 1 case in the open group. The incidence of complication was not statistically different between the groups. Conclusion: The laparoscopic technique showed a similar mechanical complication rate compared to the open technique. Incisional hernia developed more frequently in the laparoscopic group, and incisional hernia requires more careful closure technique.
There is some controversy about the safety of renal transplantation in patients with an augmentation cystoplasty. The purpose of this study is to assess the early and long-term results of renal transplantation in 6 patients who underwent augmentation cystoplasty to correct bladder dysfunction. Methods: We retrospectively reviewed the surgical outcome of renal transplants in 6 recipients with augmentation cystoplasty including one ileal conduit. The etiology of bladder dysfunction was neurogenic bladder with detrusor hyperreflexia (4 pediatric patients) and renal tuberculosis (2 adult patients). Augmentation cystoplasty was performed before transplantation in all patients. The bowel segments used in the augmentation cystoplasty included stomach in 2 (including one revision case with ileum), ileum in 3, ileocecal segments in 1, and sigmoid colon in 1 patients. The mean patient`s age at transplantation was 25.5 years. Four transplants were from living donors. The donor ureter was anastomosed to ileal conduit in 1, native bladder in 2, and the bowel segment in 3 patients. Results: All transplanted kidneys were functioning at a mean follow-up of 103 months (range 5 to 220). The mean serum creatinine level was 1.0 mg/dl (range 0.7 to 1.8). Acute rejection was diagnosed in protocol biopsy in one patient without graft function deterioration. Four patients admitted for febrile urinary infection during the follow up periods. Conclusions: Augmentation cystoplasty is a safe and effective method to restore the renal function in patients who have noncompliant bladders. Renal transplantation can be performed safely after augmentation cystoplasty. (J Korean Soc Transplant 2008;22:220-225)
Purpose: To know the current trend of the annual number of AAA patients in Korea and treatment modality, we attempted to investigate the numbers of patients diagnosed with AAA and the number of patients who underwent open or endovascular treatment of AAA in Korea during the last 6 years. Methods: To investigate the number of AAA patients, we searched for ruptured AAA and AAA without description of rupture disease from the database of Health Insurance Reimbursement Association (HIRA) by searching the disease code of HIRA I71.3 (ruptured AAA) and I71.4 (AAA without description of rupture) during the period between 2003 and 2009. To investigate the number of patients who underwent treatment for AAA, we searched for code O 2036, O 2034, O 0223, O 0224 (open surgical repair) and M 6612 (endovascular aneurysm repair, EVAR). To discern the number of AAA-related deaths in Korea during the same period, we depended on the database of the Statistics Korea. Results: We found that the number of AAA patients and treatment of AAA were rapidly increasing recently after the inception of the reimbursement for EVAR by the HIRA. But the number of AAA-related deaths did not significantly change during the same period in Korea. Conclusion: After observing that the number of patients with AAA and its treatment rapidly increased while the number of AAA-related death did not increase, we can assume that it is the result of increase of patients detection rather than that of prevalence of AAA and also think that many AAA patients are still under-detected in Korea. To cope with the increasing number of AAA patients and to facilitate detection of hidden AAA patients, we would like to propose a nationwide screening program of AAA for a selected group of the population. (J Korean Surg Soc 2011;80:125-130)
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