Does laparoscopic omentectomy reduce CAPD catheter malfunction: A three-arm pilot randomized trial

Aditya Baksi; Krishna Asuri; Seenu Vuthaluru; Raj K Yadav; Om Prakash Prajapati; Virinder K Bansal; Subodh Kumar; Sandeep Mahajan; Dipankar Bhowmik; Arvind Bagga; Sanjay K Agarwal

doi:10.4103/ijn.ijn_168_21

Advertisment

About us | Subscription | e-Alerts | Feedback | Login

| | | | |

Users Online:1099

Official publication of the Indian Society of Nephrology

~ Next article

~ Previous article

~ Table of Contents

~ Similar in PUBMED

~ Search Pubmed for

~ Search in Google Scholar for

~Related articles

~ Citation Manager

~ Access Statistics

~ Reader Comments

~ Email Alert *

~ Add to My List *

* Requires registration (Free)

Article Access Statistics

Viewed	415

Printed	13

Emailed	0

PDF Downloaded	17

Comments	[Add]

Click on image for details.

ORIGINAL ARTICLE

Year : 2022 | Volume : 32 | Issue : 4 | Page : 299-306

Does laparoscopic omentectomy reduce CAPD catheter malfunction: A three-arm pilot randomized trial

Aditya Baksi¹, Krishna Asuri¹, Seenu Vuthaluru¹, Raj K Yadav², Om Prakash Prajapati¹, Virinder K Bansal¹, Subodh Kumar¹, Sandeep Mahajan², Dipankar Bhowmik², Arvind Bagga³, Sanjay K Agarwal²
¹ Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
² Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
³ Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Seenu Vuthaluru
Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi - 110 029
India

Source of Support: None, Conflict of Interest: None

Check

DOI: 10.4103/ijn.ijn_168_21

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.

[FULL TEXT] [PDF]*