Peritoneal dialysis is a good and safe method to handle end-stage renal diseases while waiting arteriovenous fistula for hemodalysis or a renal transplantation. However, there are some catheter related complications such as obstruction and peritonitis. Those complications are usually treated by laparotomy, but with the increasing use of the minimally invasive surgery, laparoscopy became a therapeutic option. The aim of the present study is to evaluate the open vs. the laparoscopic approach in the management of the related catheter complications of peritoneal dialysis. Twenty patients developed 35 catheter related events treated surgically (obstruction 60%, peritonitis 34,3% and tunnel infection in 5,7%). The open procedure was used 22 times and the laparoscopic 13. Through laparoscopy, it was possible to remove the obstruction and keep the catheter in 80%, while when the open approach was used 100% had to be replaced or removed. Peritoneal dyalysis was restarted later in the open method. Our data suggest that laparoscopy is an effective and safe method for the management of the catheter related complications of peritoneal dialysis, allowing direct visualization and manipulation of the peritoneal cavity and decreasing of the time span until resuming full utilization of the cateter.
Catheter complications; Dialysis; Peritoneal dialysis; Laparoscopy
