Laparoscopic Lysis of Obstruction of a Peritoneal Dialysis Catheter

KITAMURA Hiroaki, TSUBOI Kazuto, KASHIWAGI Hideyuki, YOSHIMOTO Kazuhisa, KAJIMOTO Tetuya, YANAGA Katuhiko

doi:10.3919/jjsa.78.11

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Other Title

難治性腹膜透析カテーテル閉塞に対する腹腔鏡下閉塞解除術の経験
臨床経験難治性腹膜透析カテーテル閉塞に対する腹腔鏡下閉塞解除術の経験
リンショウケイケンナンチセイフクマクトウセキカテーテルヘイソクニタイスルフククウキョウカヘイソクカイジョジュツノケイケン

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Abstract

Continuous ambulatory peritoneal dialysis (CAPD) catheter dysfunction is one of the most common complications of peritoneal dialysis. For patients with a refractory obstructed catheter, replacement of the catheter or conversion to hemodialysis is required. We report the usefulness of exploratory peritoneoscopy and lysis of obstruction in such patients. <Patients> Five patients (mean age : 56 years, 4 men) with refractory obstruction of a peritoneal dialysis catheter underwent exploratory peritoneoscopy. <Result> The cause of obstruction was wrapping by the omentum in 4 cases, and by fatty appendices of the colon in one patient. The average operative time was 55 min (36-103 min), and the patients resumed CAPD 1 to 3 (median 2) days postoperatively. One case required reoperation because of recurrent catheter obstruction due to omental wrapping, which was relieved with the addition of omentectomy ; this case subsequently remained free of recurrent occlusion. <Conclusion> For refractory obstruction of a peritoneal dialysis catheter, exploratory laparoscopy and lysis of the obstruction is a useful option.

Journal

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 78 (1), 11-15, 2017

Japan Surgical Association

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