Tenckhoff Catheter Implantation Technique and Outcomes of Continuous Ambulatory Peritoneal Dialysis in Buddhachinaraj Phitsanulok Hospital - เทคนิคและผลลัพธ์ของการผ่าตัดวางสายนำน้ายาล้างไตทางช่องท้องสำหรับผู้ป่วยไตวายระยะสุดท้าย: ประสบการณ์โรงพยาบาลศูนย์

Abstract

             This report presents a technique on Tenckhoff catheter implantation and outcome of continuous ambulatory peritoneal dialysis (CAPD) in Buddhachinaraj Phitsanulok Hospital. The study design was retrospective descriptive on experiences on Tenckhoff catheters implantation in a regional hospital. Data were collected from medical records, surgical reports, and CAPD register database in 3 fiscal years from 2008 to 2010. The data were analyzed and presented in frequency, percentage, average, and standard deviation. The subjects were 205 patients with Tenckhoff catheter implantation, 195 patients were diagnosed with end stage renal failure and on long term CAPD for outcome study. Surgical insertion of Tenckhoff catheters were performed by general surgeon using open surgical techniques with midline approach under general anesthesia. Average operative time was 20 minutes. After the operation, patients had to stay in hospital for 2 days. Immediate post-operative complication was little. Early mechanical complications within the first month after Tenckhoff insertion were reported in 11 (5.6%) out of 195 patients including obstruction (6 patients), mal position (3) and catheter leakage (1). Seventeen patients (8.7%) suffered from mechanical complications after 1 month following catheter insertion such as obstruction (8 patients), mal-position (5) and leakage (3). Through the 3 fiscal years, the rate of infection was reported as a peritonitis case in every 9.87 patient-months which was higher than standard. The catheter survival was short (11.5 months). In conclusion, conventional surgical techniques resulted in limited complications. However, peritonitis remained the major late complication of CAPD. Further research to find out the exact causes should be done. Meanwhile, health education for patients with CAPD and counseling technique should be reviewed.

Key words: implantation technique of Tenckhoff catheters, continuous ambulatory peritoneal dialysis (CAPD), outcome of Tenckhoff catheter implantation