Abstract:

Objective: To compare the clinical effect and cost between laparoscopic and open surgery that resolve the omental wrapping of peritoneal dialysis catheter. Methodology: Thirty patients with peritoneal dialysis were diagnosed omental wrapping of peritoneal dialysis catheter during January 2006 to June 2011. According to patients' willingness, two types of operations were performed: laparoscopic surgery (the catheter was released from the wrapping omentum and repositioned in the pelvis under laparoscopy, n=18) and open surgery (the omentum-wrapped catheter was removed and a new catheter was reimplanted, n=12). The clinical parameters were collected, such as general conditions, operative time, incision length, operation cost and recurrence of omental wrapping. Results: The parameters such as general conditions, recurrence of omental wrapping (38.9% vs 33.3%) between two groups showed no significant statistical difference respectively (P>0.05). The operative time of laparoscopic surgery was shorter than that of open surgery (26.0 ± 8.51 vs 92.8 ± 16.1 mins) (P<0.05). The incision length of laparoscopic surgery was shorter than that of open surgery (1.52 ± 0.43 vs 4.38 ± 1.30 cm) (P<0.05).The cost of laparoscopic surgery was more expensive than that of open surgery (7392 ± 522 vs 2823 ± 159 yuan) (P<0.05). Conclusions: Although the laparoscopic surgery showed advantages of small trauma and a short span of time, high cost and the recurrence of omental wrapping of peritoneal dialysis catheter still existed. There were no obvious advantages between two types of operations in resolving omental wrapping of peritoneal dialysis catheter. Laparoscopic technique (repositioning with omentum folding, partial omentectomy) may be helpful in preventing the recurrence of omental wrapping.