Velázquez MJD, Esquivel GF, Vázquez GMÁ, Ramírez BÉJ

Language: Spanish
References: 0
Page: 31-38
PDF size: 177.27 Kb.

ABSTRACT

Objective: To compare the incidence of post-operative complications between two Tenckhoff catheter implanting techniques for peritoneal dialysis: the conventional versus a modified technique.
Setting: Regional PEMEX Hospital in Salamanca, Gto, Mexico (second level health care hospital).
Design: Randomized clinical assay.
Statistical analysis: Student’s t test, chi square (χ²) test, and Fisher’s exact test.
Patients and methods: The study was performed from January 2004 to December 2006 in patients with chronic renal failure, needing peritoneal dialysis. Patients were divided randomly in two groups; one group operated with the conventional technique and the other was subjected to a modified technique that consisted of overlapping the posterior aponeurosis of the abdominal rectum to the catheter exit with polyglycolic acid (gauge 0) to attain a 75° curvature for the catheter. Analyzed variables were leak of the dialysis solution through the surgical wound, obstruction of the catheter due to omentum, clotting or fibrin formation, hemorrhage, migration of the catheter, infectious peritonitis, infection of the surgical site.
Results: We analyzed 70 patients with chronic renal failure, needing implantation of a Tenckhoff catheter. There were 41 (58.5%) men and 29 (41.5%) women, average age of 64 years, range from 19 to 90 years of age. Patients were randomly assigned to the study groups; each group consisted of 35 patients. The group subjected to conventional surgery presented 27 (77%) patients with dysfunction and the group subjected to the modified technique had seven (20%) patients. The difference was statistically significant at p ‹ 0.05. The encountered dysfunctions were leakage, occlusion of catheter flow, migration of the catheter, and bleeding.
Conclusion: Patients subjected to the modified technique, as compared with the conventional operated patients, presented less post-operative dysfunction, and peritoneal dialysis could be started immediately with less dysfunctional risk.