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. 2022 Jul-Aug;32(4):299-306.
doi: 10.4103/ijn.ijn_168_21. Epub 2022 May 20.

Does Laparoscopic Omentectomy Reduce CAPD Catheter Malfunction: A Three-arm Pilot Randomized Trial

Aditya Baksi  1 , Krishna Asuri  1 , Seenu Vuthaluru  1 , Raj K Yadav  2 , Om Prakash Prajapati  1 , Virinder K Bansal  1 , Subodh Kumar  1 , Sandeep Mahajan  2 , Dipankar Bhowmik  2 , Arvind Bagga  3 , Sanjay K Agarwal  2
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Does Laparoscopic Omentectomy Reduce CAPD Catheter Malfunction: A Three-arm Pilot Randomized Trial

Aditya Baksi et al. Indian J Nephrol. 2022 Jul-Aug.

Abstract

Introduction: Catheter malfunction secondary to omental wrapping is a frequent complication of continuous ambulatory peritoneal dialysis (CAPD). Of the various methods of peritoneal dialysis catheter insertion (PDCI), open surgical insertion under local anesthesia is most widely practiced. Laparoscopic omentectomy is often undertaken as a salvage procedure in case of malfunctioning catheters. However, there is no randomized controlled trial (RCT) to evaluate the role of prophylactic laparoscopic omentectomy on catheter function. This pilot RCT was undertaken to evaluate the impact of laparoscopic omentectomy on the incidence of catheter malfunction.

Materials and methods: Consecutive patients were randomized into three groups: laparoscopic PDCI with omentectomy (Group A), laparoscopic PDCI without omentectomy (Group B) and open surgical PDCI (Group C). The primary outcome was the incidence of catheter malfunction at 6 weeks and 3 months.

Results: Forty-one patients completed follow-up, with 16, 11, and 14 patients in Groups A, B, and C, respectively. Incidence of catheter malfunction was 6.2%, 27.3%, and 14.3% in Groups A, B, and C, respectively, at 6 weeks and 6.2%, 36.4%, and 21.4% at 3 months, respectively. In patients with previously failed catheter insertion (n = 23), malfunction at 3 months was 8.3% (1/12) in patients who had omentectomy, compared with 45.5% (5/11) in those who did not (P = 0.069). Operating time was significantly higher (P < 0.001) in Group A.

Conclusions: Laparoscopic omentectomy may be associated with a lower incidence of catheter malfunction, especially in patients with previously failed peritoneal dialysis catheter. Data from this pilot RCT can be used to design a large trial with an adequate number of patients.

Keywords: CKD; Chronic kidney disease; end-stage renal disease; peritoneal dialysis; renal replacement therapy Trial registration number: CTRI/2018/02/011871.

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Conflict of interest statement

There are no conflicts of interest.

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Figure 1
CONSORT (Consolidated Standards of Reporting Trials) diagram
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References

    1. Tam P. Peritoneal dialysis and preservation of residual renal function. Perit Dial Int. 2009;29((Suppl 2)):S108–10. - PubMed
    1. Al-Hwiesh AK. Percutaneous peritoneal dialysis catheter insertion by a nephrologist: A new, simple, and safe technique. Perit Dial Int. 2014;34:204–11. - PMC - PubMed
    1. van Laanen JHH, Cornelis T, Mees BM, Litjens EJ, van Loon MM, Tordoir JHM, et al. Randomized controlled trial comparing open versus laparoscopic placement of a peritoneal dialysis catheter and outcomes: The CAPD I trial. Perit Dial Int J. 2018;38:104–12. - PubMed
    1. Wright MJ, Bel'eed K, Johnson BF, Eadington DW, Sellars L, Farr MJ. Randomized prospective comparison of laparoscopic and open peritoneal dialysis catheter insertion. Perit Dial Int. 1999;19:372–5. - PubMed
    1. Reissman P, Lyass S, Shiloni E, Rivkind A, Berlatzky Y. Placement of a peritoneal dialysis catheter with routine omentectomy--Does it prevent obstruction of the catheter? Eur J Surg Acta Chir. 1998;164:703–7. - PubMed