OUTCOMES OF SINGLE-TROCAR LAPAROSCOPIC PERITONEAL DIALYSIS CATHETER PLACEMENT FOR END-STAGE RENAL DISEASE AT VIETNAM NATIONAL CHILDREN'S HOSPITAL
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Abstract
Objective: To evaluate outcomes of single-trocar laparoscopic peritoneal dialysis (PD) catheter placement and factors associated with catheter survival in children with end-stage renal disease.
Methods: A retrospective study of 136 children (156 placements) at Vietnam National Children's Hospital, 2021-2024. Technical success was defined as absence of early (<= 30-day) mechanical complications; catheter survival was estimated by Kaplan-Meier (censoring transplantation and death); associated factors were analysed by Cox regression.
Results: Median age 11.2 years; 59.6% male. The greater omentum covered the Douglas pouch in 82.7%; 87.8% underwent omental management, adhesiolysis or closure of a patent processus vaginalis through the umbilical trocar alone. Technical success was 98.1%. At three months, hematocrit increased and urea and creatinine decreased (p < 0.001). Late peritonitis (17.9%) predominated. Catheter survival at 1, 2 and 3 years was 87.4%, 77.7% and 68.1%; the longest functioning catheter reached 66.7 months. Omental management (HR 0.36; 95%CI 0.19-0.70) and older age (HR 0.91) were associated with lower failure risk.
Conclusion: Single-trocar laparoscopic PD catheter placement is safe and effective; omental management is associated with better catheter survival.
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Keywords
chronic renal failure, peritoneal dialysis, catheter, single-trocar laparoscopy, children
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