Efficacy and safety of repositioning malfunctioning peritoneal dialysis catheters with fluoroscopically guided guidewire manipulation.

IF 1.1 4区医学 Q3 UROLOGY & NEPHROLOGY

Clinical nephrology Pub Date : 2025-05-13 DOI:10.5414/CN111605

Ron Cheuk Lau Wong, Eric Wai Pan Cheung, Agnes Wong, Brian Kar Ho Lee, Ka King Cheng, Danny Hing Yan Cho

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引用次数: 0

Abstract

Objective: To evaluate the efficacy and safety of fluoroscopic-guided repositioning of peritoneal dialysis (PD) catheter using guidewire manipulation in our center in Hong Kong.

Materials and methods: All patients underwent fluoroscopic-guided PD catheter repositioning in our institution between November 1, 2017 to December 31, 2022 were reviewed. Patients fulfilling the selection criteria were identified, with their clinical notes, relevant radiological reports, interventional images, and operative records retrospectively reviewed. The success rate was evaluated, with the technical success defined as improved free contrast flow or return of continuous steady stream after test injection of normal saline immediately after repositioning; clinical success defined as functional peritoneal dialysis catheter at 30 days post-repositioning. Logistic regression models were applied to evaluate the variables associated with successful manipulation. Post-manipulation complications and the PD time gained after successful manipulation were also reviewed.

Results: 46 patients were identified and 54 procedures were performed over the study period. 35 of the interventions (64.8%) resulted in technical success, and 25 cases (46.3%) resulted in clinical success. The median extra PD time gained after successful manipulation was 619 days (IQR, 313.5 - 1,007; range, 110 - 1,872). The median for number of days of hospital stay after the procedure was 2.5 days (IQR, 2 - 5; range, 1 - 65). Seven cases (13.0%) developed immediate complications, with most cases being peritonitis (n = 5), and all were successfully treated with intraperitoneal antibiotics. There was no associated mortality.

Conclusion: Fluoroscopic-guided repositioning of the PD catheter was found to be a useful and safe treatment option for malfunctioning PD catheter and could potentially spare patients from the conventional operative intervention.

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透视引导导丝复位腹膜透析管的有效性和安全性。

目的：评价我中心在透视下采用导丝手法置管腹膜透析（PD）导管复位的有效性和安全性。材料与方法：回顾2017年11月1日至2022年12月31日在我院行透视引导下PD导管重新定位的所有患者。确定符合选择标准的患者，回顾性回顾他们的临床记录、相关放射报告、介入图像和手术记录。评估成功率，技术成功定义为重新定位后立即试验注射生理盐水后自由造影剂流动改善或恢复连续稳定流动；临床成功定义为重新定位后30天腹膜透析导管功能。应用逻辑回归模型评估与成功操作相关的变量。我们也回顾了操作后并发症和成功操作后获得的PD时间。结果：在研究期间，共确定了46例患者，进行了54次手术。其中技术成功35例（64.8%），临床成功25例（46.3%）。成功操作后获得的额外PD时间中位数为619天(IQR, 313.5 - 1,007；范围，110 - 1872)。术后住院天数中位数为2.5天(IQR, 2 - 5；范围：1 - 65)。7例（13.0%）出现直接并发症，以腹膜炎为主（n = 5），均经腹腔内抗生素治疗成功。没有相关的死亡率。结论：透视引导下PD导管重新定位是一种有效且安全的治疗PD导管故障的方法，可以使患者免于传统的手术干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nephrology 医学-泌尿学与肾脏学

CiteScore

2.10

自引率

9.10%

发文量

138

审稿时长

4-8 weeks

期刊介绍： Clinical Nephrology appears monthly and publishes manuscripts containing original material with emphasis on the following topics: prophylaxis, pathophysiology, immunology, diagnosis, therapy, experimental approaches and dialysis and transplantation.