Patients undergoing peritoneal dialysis catheter placement via fluoroscopy and ultrasound-guidance experienced significantly fewer complications at 1 year post-insertion than did patients whose catheters were placed laparoscopically.
The first of two study groups received catheters using fluoroscopy and ultrasound guidance under conscious sedation by interventional radiologists. In the second group, the catheters were inserted using laparoscopy under general anesthesia by surgeons.
"Our results showed that the overall complications at 1 year were significantly higher for the laparoscopic group and that the laparoscopic approach is more likely to be complicated by catheter malfunction and peritonitis," said Ahmed Kamel Abdel Aal, chief of the division of Interventional Radiology at the University of Alabama at Birmingham.
The image-guided insertion technique may allow for expeditious catheter placement in late-referred patients with end-stage renal disease, thus facilitating urgent-start peritoneal dialysis and avoiding the need for temporary vascular-access catheters.
Source: American Roentgen Ray Society