Abstract:

Objective: To compare the efficacy and safety between laparoscopic and  conventional placement of peritoneal dialysis (PD) catheters prospectively in patients with end-stage renal disease (ESRD)．Methodology: Fifty patients with ESRD were selected as candidates, who received catheter implantation and CAPD therapy from December 2008 to April 2010 for the first time．They were randomly divided into group A (with laparoscopic placement of PD catheter, n=25) and group B (with conventional placement of PD catheter, n=25). The clinical information such as complications, survival time, quit of dialysis, death, etc was collected. At same time, the liver and renal functions between preoperative and postoperative stage were compared between two groups. Results: Till to June 2010, 5 patients (10%) died, including 2 in group A and 3 cases in group B. The survival rate of 10 months was 86.6% (group A) and 82.9% (group B), respectively (P> 0.05). The total incidence of peritonitis was 0.29 times/patient year, with a detailed figure of 0.24 for group A and 0.34 times/patient year for group B respectively (P>0.05)．The time interval between catheter implanting and onset of peritonitis was 31.8±23.8 and 14.9±10.4 weeks for group A and group B respectively (P>0.05). There was no catheter migration in group A, while 4 cases in group B (P>0.05).The other complications of catheter between two groups were not significantly different (P>0.05). In group A, the liver and kidney functions of before and after surgery were no significant difference. Conclusions: The incidence of peritonitis shortly after operation in group A was slightly decreased. More importantly, it can solve the problem of catheter migration through laparoscopic placement. Meanwhile, the general anesthesia and artificial pneumoperitoneum did not affact the liver and renal functions of patients with ESRD.