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Article: A prospective randomized study comparing tenckhoff catheters inserted using the triple incision method with standard swan neck catheters

TitleA prospective randomized study comparing tenckhoff catheters inserted using the triple incision method with standard swan neck catheters
Authors
KeywordsCatheter implantation
Dialysis catheter insertion
Tenckhoff catheter insertion
Triple incision method
Issue Date2010
PublisherMultimed, Inc. The Journal's web site is located at http://pdiconnect.com
Citation
Peritoneal Dialysis International, 2010, v. 30 n. 1, p. 56-62 How to Cite?
AbstractBackground and Objective: The downward directed exit of the swan neck catheter may decrease the risk of exitsite infection (ESI). The percentage of migrations of the swan neck catheter seems to be less than the conventional Tenckhoff catheter and the swan neck catheter is more expensive and cannot be manipulated by guidewire technique if tip migration occurs. In this study, the conventional Tenckhoff catheter was used. The straight tunnel was converted to an arcuate one using the triple incision method, resulting in a downward directed exit. The arcuate tunnel was created by passing the catheter through an additional incision located between the paramedian incision and the exit site. We compared the infective and mechanical complications of the Tenckhoff catheter with a downward exit, implanted using the triple incision method, with the swan neck catheter. Patients and Methods: 101 new peritoneal dialysis patients were prospectively randomized to receive either the Tenckhoff catheter with a downward exit, implanted using the triple incision method, or the swan neck catheter. Each patient was followed up for 24 months. 50 patients were in the triple incision method group (TIMG) and 51 were in the swan neck catheter group (SNCG). Results: Over a mean period of 18.9 ± 8.0 months of follow-up, ESI occurred in 35 patients (70%) in TIMG and 37 patients (72.5%) in SNCG (p = 0.83). The ESI rates were 0.71 and 1.0 episodes/catheter-year in TIMG and SNCG respectively (p = 0.21). The peritonitis rates were similar in the 2 groups (0.64 episodes/year in TIMG and 0.68 episodes/ year in SNCG, p = 0.47). More patients in TIMG had tip migration [15 patients (30%) in TIMG vs 10 patients (19.6%) in SNCG] but the difference was not statistically significant. Repositioning of the catheter by guidewire manipulation was successful in patients in TIMG but not in SNCG. Overall catheter survival at 12 and 24 months was 95% and 83% in TIMG and 93% and 79% in SNCG respectively (p = 0.72). Conclusion: By using the conventional Tenckhoff catheter with a downward exit created using the triple incision method, high catheter survival rates with infective and mechanical complication rates similar to those of the swan neck catheter can be achieved. The triple incision method has the additional advantages of lower cost and the catheter can be manipulated by guidewire technique if tip migration occurs. © 2010 International Society for Peritoneal Dialysis.
Persistent Identifierhttp://hdl.handle.net/10722/129289
ISSN
2015 Impact Factor: 1.298
2015 SCImago Journal Rankings: 0.683
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYip, Ten_HK
dc.contributor.authorLui, SLen_HK
dc.contributor.authorTse, KCen_HK
dc.contributor.authorXu, Hen_HK
dc.contributor.authorNg, FSKen_HK
dc.contributor.authorCheng, SWen_HK
dc.contributor.authorChan, TMen_HK
dc.contributor.authorLai, KNen_HK
dc.contributor.authorLo, WKen_HK
dc.date.accessioned2010-12-23T08:34:44Z-
dc.date.available2010-12-23T08:34:44Z-
dc.date.issued2010en_HK
dc.identifier.citationPeritoneal Dialysis International, 2010, v. 30 n. 1, p. 56-62en_HK
dc.identifier.issn0896-8608en_HK
dc.identifier.urihttp://hdl.handle.net/10722/129289-
dc.description.abstractBackground and Objective: The downward directed exit of the swan neck catheter may decrease the risk of exitsite infection (ESI). The percentage of migrations of the swan neck catheter seems to be less than the conventional Tenckhoff catheter and the swan neck catheter is more expensive and cannot be manipulated by guidewire technique if tip migration occurs. In this study, the conventional Tenckhoff catheter was used. The straight tunnel was converted to an arcuate one using the triple incision method, resulting in a downward directed exit. The arcuate tunnel was created by passing the catheter through an additional incision located between the paramedian incision and the exit site. We compared the infective and mechanical complications of the Tenckhoff catheter with a downward exit, implanted using the triple incision method, with the swan neck catheter. Patients and Methods: 101 new peritoneal dialysis patients were prospectively randomized to receive either the Tenckhoff catheter with a downward exit, implanted using the triple incision method, or the swan neck catheter. Each patient was followed up for 24 months. 50 patients were in the triple incision method group (TIMG) and 51 were in the swan neck catheter group (SNCG). Results: Over a mean period of 18.9 ± 8.0 months of follow-up, ESI occurred in 35 patients (70%) in TIMG and 37 patients (72.5%) in SNCG (p = 0.83). The ESI rates were 0.71 and 1.0 episodes/catheter-year in TIMG and SNCG respectively (p = 0.21). The peritonitis rates were similar in the 2 groups (0.64 episodes/year in TIMG and 0.68 episodes/ year in SNCG, p = 0.47). More patients in TIMG had tip migration [15 patients (30%) in TIMG vs 10 patients (19.6%) in SNCG] but the difference was not statistically significant. Repositioning of the catheter by guidewire manipulation was successful in patients in TIMG but not in SNCG. Overall catheter survival at 12 and 24 months was 95% and 83% in TIMG and 93% and 79% in SNCG respectively (p = 0.72). Conclusion: By using the conventional Tenckhoff catheter with a downward exit created using the triple incision method, high catheter survival rates with infective and mechanical complication rates similar to those of the swan neck catheter can be achieved. The triple incision method has the additional advantages of lower cost and the catheter can be manipulated by guidewire technique if tip migration occurs. © 2010 International Society for Peritoneal Dialysis.en_HK
dc.languageengen_US
dc.publisherMultimed, Inc. The Journal's web site is located at http://pdiconnect.comen_HK
dc.relation.ispartofPeritoneal Dialysis Internationalen_HK
dc.subjectCatheter implantationen_HK
dc.subjectDialysis catheter insertionen_HK
dc.subjectTenckhoff catheter insertionen_HK
dc.subjectTriple incision methoden_HK
dc.subject.meshAdult-
dc.subject.meshCatheters-
dc.subject.meshEquipment Design-
dc.subject.meshFemale-
dc.subject.meshPeritoneal Dialysis - instrumentation-
dc.titleA prospective randomized study comparing tenckhoff catheters inserted using the triple incision method with standard swan neck cathetersen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0896-8608&volume=30&issue=1&spage=56&epage=62&date=2010&atitle=A+prospective+randomized+study+comparing+tenckhoff+catheters+inserted+using+the+triple+incision+method+with+standard+swan+neck+catheters-
dc.identifier.emailChan, TM: dtmchan@hku.hken_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.authorityChan, TM=rp00394en_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.3747/pdi.2008.00240en_HK
dc.identifier.pmid20056980-
dc.identifier.scopuseid_2-s2.0-77957660811en_HK
dc.identifier.hkuros178484en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77957660811&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume30en_HK
dc.identifier.issue1en_HK
dc.identifier.spage56en_HK
dc.identifier.epage62en_HK
dc.identifier.isiWOS:000273418100010-
dc.publisher.placeCanadaen_HK
dc.identifier.scopusauthoridYip, T=7004283977en_HK
dc.identifier.scopusauthoridLui, SL=7102379130en_HK
dc.identifier.scopusauthoridTse, KC=7102609864en_HK
dc.identifier.scopusauthoridXu, H=55493889300en_HK
dc.identifier.scopusauthoridNg, FSK=7103125634en_HK
dc.identifier.scopusauthoridCheng, SW=36856415600en_HK
dc.identifier.scopusauthoridChan, TM=7402687700en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK
dc.identifier.scopusauthoridLo, WK=7201502414en_HK

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