Surgical versus percutaneous catheter placement for peritoneal dialysis: an updated systematic review and meta-analysis
Background No consensus currently exists regarding the optimal approach for peritoneal dialysis catheter placement. We aimed to compare the outcomes of percutaneous and surgical peritoneal dialysis catheter placement. Methods A systematic review of the literature was performed using the MEDLINE, Coc...
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| Veröffentlicht in: | Journal of nephrology 2021-10, Vol.34 (5), p.1681-1696 |
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| creator | Esagian, Stepan M. Sideris, Georgios A. Bishawi, Muath Ziogas, Ioannis A. Lehrich, Ruediger W. Middleton, John P. Suhocki, Paul V. Pappas, Theodore N. Economopoulos, Konstantinos P. |
| description | Background
No consensus currently exists regarding the optimal approach for peritoneal dialysis catheter placement. We aimed to compare the outcomes of percutaneous and surgical peritoneal dialysis catheter placement.
Methods
A systematic review of the literature was performed using the MEDLINE, Cochrane Library, and Scopus databases (end-of-search date: August 29th, 2020). We included studies comparing percutaneous (blind, under fluoroscopic/ultrasound guidance, and “half-perc”) and surgical peritoneal dialysis catheter placement (open and laparoscopic) in terms of their infectious complications (peritonitis, tunnel/exit-site infections), mechanical complications (leakage, inflow/outflow obstruction, migration, hemorrhage, hernia, bowel perforation) and long-term outcomes (malfunction, removal, replacement, surgery required, and mortality).
Results
Thirty-four studies were identified, including thirty-two observational studies (twenty-six retrospective and six prospective) and two randomized controlled trials. Percutaneous placement was associated with significantly lower rates of tunnel/exit-site infection [relative risk (RR) 0.72, 95% confidence interval (CI) 0.56–0.91], catheter migration (RR 0.68, 95% CI 0.49, 0.95), and catheter removal (RR 0.73, 95% CI 0.60–0.88). The 2-week and 4-week rates of early tunnel/exit-site infection were also lower in the percutaneous group (RR 0.45, 95% CI 0.22–0.93 and RR 0.41, 95% CI 0.27–0.63, respectively). No statistically significant difference was observed regarding other outcomes, including catheter survival and mechanical complications.
Conclusion
Overall, the quality of published literature on the field of peritoneal dialysis catheter placement is poor, with a small percentage of studies being randomized clinical trials. Percutaneous peritoneal dialysis catheter placement is a safe procedure and may result in fewer complications, such as tunnel/exit-site infections, and catheter migration, compared to surgical placement.
Protocol registration
PROSPERO CRD42020154951.
Graphic abstract |
| doi_str_mv | 10.1007/s40620-020-00896-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2461396143</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2461396143</sourcerecordid><originalsourceid>FETCH-LOGICAL-c324t-96c446ec72f091945ae9d040d02ae3698adc729aedb5a4735ddc9c65f1aba033</originalsourceid><addsrcrecordid>eNqNkM2L1jAQh4Mo7rr6D3jqUZDq5KttvMmLX7Dgwb2XeZPpmqVtapJuef97UyoexcOQCfM8Q_Jj7DWHdxygfZ8UNAJq2As609TbE3bNW6HqBrR5WnoueN0p0V2xFyk9AAithXrOrqTkpgXg12z7scZ7b3GsHimmNVULRbtmnCmUi8X8kzLFahnR0kRzroYQd8bnMFOxnMfxknz6UOFcrYvDTK5Kl5RpwuxtFenR01aGrpooY43zwb9kzwYcE736c96wu8-f7k5f69vvX76dPt7WVgqVa9NYpRqyrRjAcKM0knGgwIFAko3p0JWZQXJnjaqV2jlrbKMHjmcEKW_Ym2PtEsOvlVLuJ58sjePxwV6ohkvTcLWj4kBtDClFGvol-gnjpefQ73n3R9497LXn3W9F6g5po3MYkvU0W_orAoDujOmkLh3wk88lkzCfwjrnor79f7XQ8qBTIeZ7iv1DWGMJM_3reb8BVqymCw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2461396143</pqid></control><display><type>article</type><title>Surgical versus percutaneous catheter placement for peritoneal dialysis: an updated systematic review and meta-analysis</title><source>Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><source>SpringerLink Journals - AutoHoldings</source><creator>Esagian, Stepan M. ; Sideris, Georgios A. ; Bishawi, Muath ; Ziogas, Ioannis A. ; Lehrich, Ruediger W. ; Middleton, John P. ; Suhocki, Paul V. ; Pappas, Theodore N. ; Economopoulos, Konstantinos P.</creator><creatorcontrib>Esagian, Stepan M. ; Sideris, Georgios A. ; Bishawi, Muath ; Ziogas, Ioannis A. ; Lehrich, Ruediger W. ; Middleton, John P. ; Suhocki, Paul V. ; Pappas, Theodore N. ; Economopoulos, Konstantinos P.</creatorcontrib><description>Background
No consensus currently exists regarding the optimal approach for peritoneal dialysis catheter placement. We aimed to compare the outcomes of percutaneous and surgical peritoneal dialysis catheter placement.
Methods
A systematic review of the literature was performed using the MEDLINE, Cochrane Library, and Scopus databases (end-of-search date: August 29th, 2020). We included studies comparing percutaneous (blind, under fluoroscopic/ultrasound guidance, and “half-perc”) and surgical peritoneal dialysis catheter placement (open and laparoscopic) in terms of their infectious complications (peritonitis, tunnel/exit-site infections), mechanical complications (leakage, inflow/outflow obstruction, migration, hemorrhage, hernia, bowel perforation) and long-term outcomes (malfunction, removal, replacement, surgery required, and mortality).
Results
Thirty-four studies were identified, including thirty-two observational studies (twenty-six retrospective and six prospective) and two randomized controlled trials. Percutaneous placement was associated with significantly lower rates of tunnel/exit-site infection [relative risk (RR) 0.72, 95% confidence interval (CI) 0.56–0.91], catheter migration (RR 0.68, 95% CI 0.49, 0.95), and catheter removal (RR 0.73, 95% CI 0.60–0.88). The 2-week and 4-week rates of early tunnel/exit-site infection were also lower in the percutaneous group (RR 0.45, 95% CI 0.22–0.93 and RR 0.41, 95% CI 0.27–0.63, respectively). No statistically significant difference was observed regarding other outcomes, including catheter survival and mechanical complications.
Conclusion
Overall, the quality of published literature on the field of peritoneal dialysis catheter placement is poor, with a small percentage of studies being randomized clinical trials. Percutaneous peritoneal dialysis catheter placement is a safe procedure and may result in fewer complications, such as tunnel/exit-site infections, and catheter migration, compared to surgical placement.
Protocol registration
PROSPERO CRD42020154951.
Graphic abstract</description><identifier>ISSN: 1121-8428</identifier><identifier>EISSN: 1724-6059</identifier><identifier>DOI: 10.1007/s40620-020-00896-w</identifier><identifier>PMID: 33197001</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>CRD ; CRD42020154951 ; Life Sciences & Biomedicine ; Medicine ; Medicine & Public Health ; Nephrology ; Review ; Science & Technology ; Urology ; Urology & Nephrology</subject><ispartof>Journal of nephrology, 2021-10, Vol.34 (5), p.1681-1696</ispartof><rights>Italian Society of Nephrology 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>17</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000589983500001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c324t-96c446ec72f091945ae9d040d02ae3698adc729aedb5a4735ddc9c65f1aba033</citedby><cites>FETCH-LOGICAL-c324t-96c446ec72f091945ae9d040d02ae3698adc729aedb5a4735ddc9c65f1aba033</cites><orcidid>0000-0003-4856-0405 ; 0000-0001-9110-4849</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40620-020-00896-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40620-020-00896-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,39263,41493,42562,51324</link.rule.ids></links><search><creatorcontrib>Esagian, Stepan M.</creatorcontrib><creatorcontrib>Sideris, Georgios A.</creatorcontrib><creatorcontrib>Bishawi, Muath</creatorcontrib><creatorcontrib>Ziogas, Ioannis A.</creatorcontrib><creatorcontrib>Lehrich, Ruediger W.</creatorcontrib><creatorcontrib>Middleton, John P.</creatorcontrib><creatorcontrib>Suhocki, Paul V.</creatorcontrib><creatorcontrib>Pappas, Theodore N.</creatorcontrib><creatorcontrib>Economopoulos, Konstantinos P.</creatorcontrib><title>Surgical versus percutaneous catheter placement for peritoneal dialysis: an updated systematic review and meta-analysis</title><title>Journal of nephrology</title><addtitle>J Nephrol</addtitle><addtitle>J NEPHROL</addtitle><description>Background
No consensus currently exists regarding the optimal approach for peritoneal dialysis catheter placement. We aimed to compare the outcomes of percutaneous and surgical peritoneal dialysis catheter placement.
Methods
A systematic review of the literature was performed using the MEDLINE, Cochrane Library, and Scopus databases (end-of-search date: August 29th, 2020). We included studies comparing percutaneous (blind, under fluoroscopic/ultrasound guidance, and “half-perc”) and surgical peritoneal dialysis catheter placement (open and laparoscopic) in terms of their infectious complications (peritonitis, tunnel/exit-site infections), mechanical complications (leakage, inflow/outflow obstruction, migration, hemorrhage, hernia, bowel perforation) and long-term outcomes (malfunction, removal, replacement, surgery required, and mortality).
Results
Thirty-four studies were identified, including thirty-two observational studies (twenty-six retrospective and six prospective) and two randomized controlled trials. Percutaneous placement was associated with significantly lower rates of tunnel/exit-site infection [relative risk (RR) 0.72, 95% confidence interval (CI) 0.56–0.91], catheter migration (RR 0.68, 95% CI 0.49, 0.95), and catheter removal (RR 0.73, 95% CI 0.60–0.88). The 2-week and 4-week rates of early tunnel/exit-site infection were also lower in the percutaneous group (RR 0.45, 95% CI 0.22–0.93 and RR 0.41, 95% CI 0.27–0.63, respectively). No statistically significant difference was observed regarding other outcomes, including catheter survival and mechanical complications.
Conclusion
Overall, the quality of published literature on the field of peritoneal dialysis catheter placement is poor, with a small percentage of studies being randomized clinical trials. Percutaneous peritoneal dialysis catheter placement is a safe procedure and may result in fewer complications, such as tunnel/exit-site infections, and catheter migration, compared to surgical placement.
Protocol registration
PROSPERO CRD42020154951.
Graphic abstract</description><subject>CRD</subject><subject>CRD42020154951</subject><subject>Life Sciences & Biomedicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nephrology</subject><subject>Review</subject><subject>Science & Technology</subject><subject>Urology</subject><subject>Urology & Nephrology</subject><issn>1121-8428</issn><issn>1724-6059</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><recordid>eNqNkM2L1jAQh4Mo7rr6D3jqUZDq5KttvMmLX7Dgwb2XeZPpmqVtapJuef97UyoexcOQCfM8Q_Jj7DWHdxygfZ8UNAJq2As609TbE3bNW6HqBrR5WnoueN0p0V2xFyk9AAithXrOrqTkpgXg12z7scZ7b3GsHimmNVULRbtmnCmUi8X8kzLFahnR0kRzroYQd8bnMFOxnMfxknz6UOFcrYvDTK5Kl5RpwuxtFenR01aGrpooY43zwb9kzwYcE736c96wu8-f7k5f69vvX76dPt7WVgqVa9NYpRqyrRjAcKM0knGgwIFAko3p0JWZQXJnjaqV2jlrbKMHjmcEKW_Ym2PtEsOvlVLuJ58sjePxwV6ohkvTcLWj4kBtDClFGvol-gnjpefQ73n3R9497LXn3W9F6g5po3MYkvU0W_orAoDujOmkLh3wk88lkzCfwjrnor79f7XQ8qBTIeZ7iv1DWGMJM_3reb8BVqymCw</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Esagian, Stepan M.</creator><creator>Sideris, Georgios A.</creator><creator>Bishawi, Muath</creator><creator>Ziogas, Ioannis A.</creator><creator>Lehrich, Ruediger W.</creator><creator>Middleton, John P.</creator><creator>Suhocki, Paul V.</creator><creator>Pappas, Theodore N.</creator><creator>Economopoulos, Konstantinos P.</creator><general>Springer International Publishing</general><general>Springer Nature</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4856-0405</orcidid><orcidid>https://orcid.org/0000-0001-9110-4849</orcidid></search><sort><creationdate>20211001</creationdate><title>Surgical versus percutaneous catheter placement for peritoneal dialysis: an updated systematic review and meta-analysis</title><author>Esagian, Stepan M. ; Sideris, Georgios A. ; Bishawi, Muath ; Ziogas, Ioannis A. ; Lehrich, Ruediger W. ; Middleton, John P. ; Suhocki, Paul V. ; Pappas, Theodore N. ; Economopoulos, Konstantinos P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c324t-96c446ec72f091945ae9d040d02ae3698adc729aedb5a4735ddc9c65f1aba033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>CRD</topic><topic>CRD42020154951</topic><topic>Life Sciences & Biomedicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nephrology</topic><topic>Review</topic><topic>Science & Technology</topic><topic>Urology</topic><topic>Urology & Nephrology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Esagian, Stepan M.</creatorcontrib><creatorcontrib>Sideris, Georgios A.</creatorcontrib><creatorcontrib>Bishawi, Muath</creatorcontrib><creatorcontrib>Ziogas, Ioannis A.</creatorcontrib><creatorcontrib>Lehrich, Ruediger W.</creatorcontrib><creatorcontrib>Middleton, John P.</creatorcontrib><creatorcontrib>Suhocki, Paul V.</creatorcontrib><creatorcontrib>Pappas, Theodore N.</creatorcontrib><creatorcontrib>Economopoulos, Konstantinos P.</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Esagian, Stepan M.</au><au>Sideris, Georgios A.</au><au>Bishawi, Muath</au><au>Ziogas, Ioannis A.</au><au>Lehrich, Ruediger W.</au><au>Middleton, John P.</au><au>Suhocki, Paul V.</au><au>Pappas, Theodore N.</au><au>Economopoulos, Konstantinos P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical versus percutaneous catheter placement for peritoneal dialysis: an updated systematic review and meta-analysis</atitle><jtitle>Journal of nephrology</jtitle><stitle>J Nephrol</stitle><stitle>J NEPHROL</stitle><date>2021-10-01</date><risdate>2021</risdate><volume>34</volume><issue>5</issue><spage>1681</spage><epage>1696</epage><pages>1681-1696</pages><issn>1121-8428</issn><eissn>1724-6059</eissn><abstract>Background
No consensus currently exists regarding the optimal approach for peritoneal dialysis catheter placement. We aimed to compare the outcomes of percutaneous and surgical peritoneal dialysis catheter placement.
Methods
A systematic review of the literature was performed using the MEDLINE, Cochrane Library, and Scopus databases (end-of-search date: August 29th, 2020). We included studies comparing percutaneous (blind, under fluoroscopic/ultrasound guidance, and “half-perc”) and surgical peritoneal dialysis catheter placement (open and laparoscopic) in terms of their infectious complications (peritonitis, tunnel/exit-site infections), mechanical complications (leakage, inflow/outflow obstruction, migration, hemorrhage, hernia, bowel perforation) and long-term outcomes (malfunction, removal, replacement, surgery required, and mortality).
Results
Thirty-four studies were identified, including thirty-two observational studies (twenty-six retrospective and six prospective) and two randomized controlled trials. Percutaneous placement was associated with significantly lower rates of tunnel/exit-site infection [relative risk (RR) 0.72, 95% confidence interval (CI) 0.56–0.91], catheter migration (RR 0.68, 95% CI 0.49, 0.95), and catheter removal (RR 0.73, 95% CI 0.60–0.88). The 2-week and 4-week rates of early tunnel/exit-site infection were also lower in the percutaneous group (RR 0.45, 95% CI 0.22–0.93 and RR 0.41, 95% CI 0.27–0.63, respectively). No statistically significant difference was observed regarding other outcomes, including catheter survival and mechanical complications.
Conclusion
Overall, the quality of published literature on the field of peritoneal dialysis catheter placement is poor, with a small percentage of studies being randomized clinical trials. Percutaneous peritoneal dialysis catheter placement is a safe procedure and may result in fewer complications, such as tunnel/exit-site infections, and catheter migration, compared to surgical placement.
Protocol registration
PROSPERO CRD42020154951.
Graphic abstract</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>33197001</pmid><doi>10.1007/s40620-020-00896-w</doi><tpages>16</tpages><orcidid>https://orcid.org/0000-0003-4856-0405</orcidid><orcidid>https://orcid.org/0000-0001-9110-4849</orcidid></addata></record> |
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| subjects | CRD CRD42020154951 Life Sciences & Biomedicine Medicine Medicine & Public Health Nephrology Review Science & Technology Urology Urology & Nephrology |
| title | Surgical versus percutaneous catheter placement for peritoneal dialysis: an updated systematic review and meta-analysis |
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