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. 2016 Oct;29(5):699-702.
doi: 10.1007/s40620-015-0251-8. Epub 2015 Nov 30.

Simultaneous abdominal wall defect repair and Tenckhoff catheter placement in candidates for peritoneal dialysis

Maurizio Sodo  1 , Umberto Bracale  1 , Gennaro Argentino  2 , Giovanni Merola  1 , Roberta Russo  2 , Giuseppina Sannino  2 , Tania Strazzullo  1 , Domenico Russo  3
Affiliations

Simultaneous abdominal wall defect repair and Tenckhoff catheter placement in candidates for peritoneal dialysis

Maurizio Sodo et al. J Nephrol. 2016 Oct.

Abstract

Introduction: The presence of pre-existing abdominal wall defect (AWD) could represent a potential contraindication for peritoneal dialysis (PD) treatment. We report the results of our 6-year experience involving simultaneous repair of pre-existing AWD and catheter insertion for PD.

Methods: Patients with estimated glomerular filtration rate (e-GFR) 7-10 ml/min attending a single nephrology clinic between January 2008 and December 2014 were evaluated. Simultaneous AWD repair and catheter placement was performed. For inguinal (IH) or umbilical hernia (UH), a prolene mesh repair technique was adopted. Except for one case of total anaesthesia, the surgical procedure was performed under either spinal or local anaesthesia. Ceftazidime alone or in association with quinolones was administered 1 h before surgery in a single dose. Patients were discharged 2 days after surgery, and returned to the clinic twice during the 1st week for peritoneum washing (first volume of peritoneal dialysis solution: 300 ml). From week 3, volume (2000 ml) and dwells were personalized according to the patient's clinical condition; options were: incremental PD, standard PD, or continuous cycling PD. Surgical follow-up was planned at 1, 6, and 12 months.

Results: Peritoneal catheters were inserted in 170 patients. IH, UH and incisional hernia were found in 18, 2 and 1 patients, respectively. IH was bilateral in 4 patients; concomitant IH and UH occurred in 1 patient. There were no deaths, nor intra-operative complications apart from scrotal haematoma in 1 patient. Over a mean follow-up of 551 days (range 342-1274) no hernia recurrence was registered and the peritoneal catheter continued functioning without problems.

Conclusions: Simultaneous AWD repair and peritoneal catheter placement seems a reliable and safe surgical procedure that allows patients with AWD to benefit from PD treatment.

Keywords: Abdominal wall defect; Inguinal hernia; Peritoneal catheter; Peritoneal dialysis.

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Conflict of interest statement

The authors declare that they have no conflict of interest. Ethical approval All procedures performed in the present study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments. Informed consent Informed consent was obtained from all participant in the study.

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