The efficacy of deroofing procedure for the tunnel infection on chronic peritoneal dialysis in children.

DOI 8 References
  • Yoshino Atsunori
    Department of Pediatrics, Dokkyo University School of Medicine, Koshigaya Hospital Department of Nephrology, Tokyo Metropolitan Kiyose Children's Hospital
  • Honda Masataka
    Department of Nephrology, Tokyo Metropolitan Kiyose Children's Hospital
  • Hataya Hiroshi
    Department of Nephrology, Tokyo Metropolitan Kiyose Children's Hospital
  • Sakazume Satoru
    Department of Pediatrics, Dokkyo University School of Medicine, Koshigaya Hospital
  • Obata Kazuo
    Department of Pediatrics, Dokkyo University School of Medicine, Koshigaya Hospital
  • Tanaka Yuriko
    Department of Nephrology, Tokyo Metropolitan Kiyose Children's Hospital
  • Kawamura Ken
    Department of Nephrology, Tokyo Metropolitan Kiyose Children's Hospital
  • Kamiyama Yasunori
    Department of Nephrology, Tokyo Metropolitan Kiyose Children's Hospital
  • Nakai Hideo
    Department of Urology, Dokkyo University school of Medicine, Koshigaya Hospital
  • Shishido Seiichirou
    Department of Urology, Tokyo Metropolitan Kiyose Children's Hospital

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Other Title
  • 小児慢性腹膜透析患者のトンネル感染に対するカフ出し術の有効性の検討

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  deroofing procedure is performed as a surgical treatment of tunnel infection and cuff infection in patients on chronic peritoneal dialysis using double-cuff Tenckhoff catheter.<br>  Our study assessed the usefulness of deroofing procedure in comparison of time interval until the onset of post-surgery tunnel infection, or catheter survival time, between those who underwent catheter replacement after tunnel infection and those who underwent deroofing surgery.<br>  The study included 36 patients (25 males aged 0.3 to 18.8 years and 11 females aged 0.4 to 20.4 years) who underwent catheter replacement or deroofing procedure for tunnel infection in the observation period from March 1, 1991 to May 1, 2001. These patients were divided into those who were operated on by deroofing (n=29; 35 catheters: deroofing group) and those who underwent catheter replacement surgery (n=19; 32 catheters: replacement group).<br>  For the purpose of evaluating the usefulness of deroofing procedure and investigating whether, or not, the time interval until post-surgery tunnel infection, or catheter survival time, was compared between the deroofing group and the replacement group, as well as between the detected causatives in the deroofing group.<br>  There was no significant inter-group difference with regard to catheter survival time (p=0.1464). The incidence of recurrence was no more than 11.4% in the deroofing group. The incidence of peritonitis due to post-surgery tunnel infection in the replacement group was 6.2% and 11.4% in the deroofing group (p=0.2). There was no significant variation in the time interval until postderoofing tunnel infection due to gram-negative rods or due to other causatives in the deroofing group.<br>  From the above results, deroofing procedure may be a procedure worth being considered as a treatment of first choice for tunnel infection.

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