# Outcomes of Surgical Versus Percutaneous Peritoneal Dialysis Catheter Insertion Techniques: A Single-Center Experience

## TL;DR

This study compares two methods for inserting peritoneal dialysis catheters and finds similar outcomes between surgical and percutaneous techniques.

## Contribution

The study provides evidence that percutaneous catheter insertion by trained nephrologists yields comparable results to surgical insertion.

## Key findings

- Catheter survival rates were similar between surgical and percutaneous insertion methods.
- Peritonitis and mechanical complication rates were comparable between the two groups.
- Patient survival and catheter function were not significantly different between the two techniques.

## Abstract

Background

Continuous ambulatory peritoneal dialysis (CAPD) is a feasible and practical option for renal replacement therapy (RRT) in patients with end-stage renal disease (ESRD). However, the superiority of the surgical method versus the percutaneous method for peritoneal dialysis catheter (PDC) placement is not well established.

Methods

We retrospectively analyzed 91 peritoneal dialysis (PD) catheters inserted using two methods: the minilaparotomy technique performed by a surgeon (Group S, n=57) and the percutaneous technique performed by a nephrologist (Group N, n=34) over a 36-month study period.

Results

The primary PDC nonfunction rate was comparable between the two groups (3.5% vs. 3.3%). Catheter survival at one year (78.9% vs. 80%, p=0.761) and at the end of the study (61.4% vs. 66.6%, p=0.947) was higher in Group N but not statistically significant. The mean duration of catheter survival (in months) was identical in both groups (19.62±10.42 vs. 19.62±10.42), and patient survival at the end of the study was also comparable (78.9% vs. 80%, p=0.852). Peritonitis rates (per patient-year) did not differ significantly between the groups (0.15 vs. 0.10, p=0.693). Mechanical complication rates and refractory peritonitis rates were also comparable between the two groups.

Conclusion

The outcomes of percutaneously placed PDCs performed by a well-trained nephrologist were comparable to those placed by surgeons using the minilaparotomy technique. Training more nephrologists in percutaneous PDC insertion could enhance patient access and convenience in care.