Laparoscopic versus traditional peritoneal dialysis catheter insertion: a meta analysis

Abstract

Objective: The objective of this study is to compare the catheter-related complications as well as catheter survival between laparoscopic and traditional surgery in peritoneal dialysis catheter insertion.

Results: Five randomized controlled trials and 11 cohort studies were identified. Meta-analysis showed laparoscopic catheter is superior to traditional surgery in terms of controlling catheter migration (OR 0.17, 95% CI 0.08-0.33; p < 0.00001) and catheter survival rate (1-year survival rate: OR 3.05, 95% CI 1.72-5.41, p = 0.0001; 2-year survival rate: OR 2. 07, 95% CI 1.29-3.33, p = 0.0001), but slightly increases the risk of bleeding (OR 2.13, 95% CI 1.07-4.23, p = 0.03). The two groups were not significantly different in other catheter-related complications. As regards the quality of the analysis, only the migration analysis ranked A-level, while the rest fell into Class B or C. The overall research quality was moderate.

Conclusion: Laparoscopic surgery is superior to traditional surgery on reducing catheter migration and prolonging catheter survival rate according to our analysis.

Keywords: Catheter survival; complication; laparoscopy; peritoneal dialysis; peritoneal dialysis catheter insertion.