Modification of the percutaneous approach to peritoneal dialysis catheter placement under peritoneoscopic visualization: clinical results in 78 patients.

The placement of percutaneous penitoneal dialysis catheters under direct penitoneoscopic visualization is a relatively new technique for establishing peritoneal dialysis access. In this study, in which a modification of the Seldinger technique was used to facilitate the placement of the penitoneoscope, the expenience with 82 consecutive catheterization procedures in 78 patients is reported. In 2 (2.4%) of 82 catheterization procedures, we were unable to enter the penitoneal cavity but experienced no other complications unique to the percutaneous approach. Of the 80 successful catheterization procedunes, 76 represented first-time catheter placement and constituted a population subjected to life-table analysis examining catheter survival rates, the time to first cutaneous exit site or s.c. tunnel infection, and the time to first episode of peritonitis. After a followup period of 50. 1 patient yr, I I catheters were lost because of catheter dysfunction. Other clinical complications included penitoneal fluid leaks at the cutaneous exit site in I I instances (0.22/patient yr), I ReceIved December 16. 1991. Accepted April 6. 1992. 2 PortIons of this work were presented at the 1990 meetIng of the American Society of Nephrology In Washington. DC, and were published In abstract form In the Journal of the American Society ofNephrology 1990; 1:390. 3 Correspondenceto Dr. N.5. Nahman, Jr.. Renal Division. Department of Internal Medicine. The Ohio State UniversIty, N-210 Means Hall. 1654 Upham Drive. Columbus, OH 43210. 1046-6673/030 1-0 103$03.00/0 Journal of the American Society of Nephrology Copyright C 1992 by the American Society of Nephrology