A Retrospective Analytical Study to Compare Percutaneous and Surgical Placement of Peritoneal Dialysis Catheter

Peritoneal dialysis is an effective modality of renal replacement therapy in end-stage renal disease. The initial step in peritoneal dialysis management is securing the Peritoneal Dialysis Catheter (PDC). This study aims to compare the infective and mechanical complications of the surgical versus the percutaneous catheter insertion technique.

This retrospective analytical study was conducted on end-stage renal disease patients who attended the Department of Nephrology, ESIC Medical College, and Super Specialty Hospital. The study was conducted from January 2019 to June 2020. The records of 25 patients who underwent percutaneous PDC and 5 patients who underwent open surgical PDC technique were reviewed. The complications (mechanical and infective complications) at 3-, 6-, and 12-month intervals among the study groups were considered the primary outcome variables, and catheter and patient survival at 1-year interval were considered the secondary outcome variables. The student t test and the Chi-square test were used to compare the study groups. The data were analyzed via the coGuide software.

No significant differences in baseline parameters were observed among the groups (P>0.05). The infective complications, namely the peritonitis rate and the exit site infection were reported more in the surgical technique of PDC placement compared to percutaneous placement (20% vs 16% and 20% vs 0%, respectively); however, the difference was not statistically significant. Catheter migration was higher in surgical technique compared to the percutaneous technique (20% vs 4%) but it was not statistically significant.

Both the percutaneous and surgical techniques reported similar rates of complications, technique survival, and patient survival. Further randomized control trials or prospective cohort studies are needed to analyze the effectiveness and complications of these techniques.