Dataset Information

Effects of early detection of peritoneal catheter migration on clinical outcomes: 15-years experiences from a single centre.

ABSTRACT:

Aim

Catheter migration is an important cause of catheter malfunction in peritoneal dialysis (PD). The purpose of this study was to investigate the effect of early detection of catheter migration on clinical outcomes.

Methods

A retrospective review of 135 consecutive patients initiating PD immediately following catheter insertion from 2002 to 2017 was undertaken. In order to detect catheter migration without malfunction early, serial abdominal-pelvic radiographic examinations were performed according to a predefined protocol. Conservative management with rigorous catharsis was undertaken to correct catheter migration. A Kaplan-Meier method was used to calculate survival rate.

Results

Mean follow-up period was 42.8?±?34.9?months. Catheter migration occurred in 62.4%. Among them, 85.9% occurred within the first 2 weeks after catheter insertion. There were no significant associations between catheter migration and variables such as gender, obesity, DM and type of catheter. Success rate of conservative management with rigorous catharsis was 91.1%. Catheter survival at 1 and 5?years were 91.5% and 64.6% in the migration group and 81.2% and 69.9% in the non-migration group, respectively (Log-rank test, P =?0.915). Patient survival at 1 and 5?years were 96.8% and 85.8% in the migration group and 91.9% and 82.3% in the non-migration group, respectively (P =?0.792).

Conclusion

Early detection of PD catheter migration allowed the migrated tip to be easily corrected with conservative management. Once the migrated catheter tip was restored, catheter migration itself did not affect catheter survival. These findings suggest that early detection and correction of catheter migration is important for improving clinical outcomes.

SUBMITTER: Ko YK

PROVIDER: S-EPMC7187436 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Publications

Effects of early detection of peritoneal catheter migration on clinical outcomes: 15-years experiences from a single centre.

Ko Young-Kyung YK Kim Young-Baek YB Shin Won-Jae WJ Lim Chae-Ho CH Cheon Woong W Park Jung-Hwan JH Lee Jong-Ho JH Jo Young-Il YI

Nephrology (Carlton, Vic.) 20190721 5

<h4>Aim</h4>Catheter migration is an important cause of catheter malfunction in peritoneal dialysis (PD). The purpose of this study was to investigate the effect of early detection of catheter migration on clinical outcomes.<h4>Methods</h4>A retrospective review of 135 consecutive patients initiating PD immediately following catheter insertion from 2002 to 2017 was undertaken. In order to detect catheter migration without malfunction early, serial abdominal-pelvic radiographic examinations were ...[more]

PMID: 31257697

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Project description:BackgroundOesophageal perforation is an uncommon surgical emergency associated with high morbidity and mortality. The timing and type of intervention is crucial and there has been a major paradigm shift towards minimal invasive management over the last 15 years. Herein, we review our management of spontaneous and iatrogenic oesophageal perforations and assess the short- and long-term outcomes.MethodsWe performed a retrospective review of consecutive patients presenting with intra-thoracic oesophageal perforation between January 2004 and Dec 2020 in a single tertiary hospital.ResultsSeventy-four patients were identified with oesophageal perforations: 58.1% were male; mean age of 68.28 ± 13.67 years. Aetiology was spontaneous in 42 (56.76%), iatrogenic in 29 (39.2%) and foreign body ingestion/related to trauma in 3 (4.1%). The diagnosis was delayed in 29 (39.2%) cases for longer than 24 h. There was change in the primary diagnostic modality over the period of this study with CT being used for diagnosis for 19 of 20 patients (95%). Initial management of the oesophageal perforation included a surgical intervention in 34 [45.9%; primary closure in 28 (37.8%), resection in 6 (8.1%)], endoscopic stenting in 18 (24.3%) and conservative management in 22 (29.7%) patients. On multivariate analysis, there was an effect of pathology (malignant vs. benign; p = 0.003) and surgical treatment as first line (p = 0.048) on 90-day mortality. However, at 1-year and overall follow-up, time to presentation (≤ 24 h vs. > 24 h) remained the only significant variable (p = 0.017 & p = 0.02, respectively).ConclusionOesophageal perforation remains a condition with high mortality. The paradigm shift in our tertiary unit suggests the more liberal use of CT to establish an earlier diagnosis and a higher rate of oesophageal stenting as a primary management option for iatrogenic perforations. Time to diagnosis and management continues to be the most critical variable in the overall outcome.

Dataset Information

Effects of early detection of peritoneal catheter migration on clinical outcomes: 15-years experiences from a single centre.

Aim

Methods

Results

Conclusion

Publications

Effects of early detection of peritoneal catheter migration on clinical outcomes: 15-years experiences from a single centre.

Similar Datasets

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