지속적 외래 복막 투석을 위한 도관 삽입술 및 도관 관련 합병증에 대한 연구

• Published in: Annals of surgical treatment and research Vol. 62; no. 2; pp. 133 - 138
• Main Authors: 곽정면(Jung Myun Kwak), 정석인(Suk In Jung), 민연기(Youn Ki Min), 강석형(Seok Hyung Kang), 조용걸(Yong Geul Joh), 조민영(Min Young Cho), 송태진(Tae Jin Song), 이재복(Jae Bok Lee), 배정원(Jeoung Won Bae), 서성옥(Sung Ok Suh), 김영철(Young Chul Kim), 황정웅(Cheung Wung Whang), 조원용(Won Yong Cho), 김형규(Hyung Kyu Kim)
• Format: Journal Article
• Language: Korean
• Published: 대한외과학회 01.02.2002
• Subjects: 일반외과학; 카테터 관련 합병증; Catheter related complication; Continuous ambulatory peritoneal dialysis; End stage renal disease; 복막투석; 말기 신부전증
• ISSN: 2288-6575; 2288-6796

Purpose: By virtue of advances in scientific methods and technical systems, there has been a rapid growth in the number of end stage renal disease (ESRD) patients treated using continuous ambulatory peritoneal dialysis (CAPD) as their primary renal replacement therapy. However, there are various catheter related complications that are limiting factors in patient and catheter maintenance. This study was aimed at introducing of the techniques of CAPD catheter implantation designed for reducing the complication rate, as well as conducting an investigation of the incidence of CAPD catheter related complications and patient survival and catheter survival rates. Methods: We performed 234 cases of CAPD catheter implantation using a conventional surgical method (n=162, between January 1993 and December 1997) or a modified surgical method (n=72, between January 1998 and December 1999), and retrospectively reviewed the patient’s medical records to elucidate the incidence of early catheter related complications and the catheter removal rate in relation to the surgical methods. Results: There were 21 cases (23.8%) of peritonitis in the modified group, which was less than that in the conventional group (79 cases, 48.8%) (P=0.036). There were 9 cases (12.5%) of exit site and tunnel infection in the modified group, which was less than that in the conventional group (36 cases, 22.2%) (P=0.019). We were able to reduce the peritonitis as well as exit site and tunnel infection by a long segment of tunneling and immobilization of the catheter to the skin. Nine cases of leakage (5.5%) have occurred in the conventional group and one case (1.3%) in the modified group; the difference was statistically significant (P=0.046). Conclusion: These results indicate that our modified surgical methods can reduce the rate of early catheter related complications. (J Korean Surg Soc 2002;62:133-138) KCI Citation Count: 0