ABSTRACT
Objective:To assess two methods for peritoneal dialysis catheter removal in elderly patients on peritoneal dialysis.Methods:A retrospective cohort study was conducted and clinical data were collected for 107 elderly patients on peritoneal dialysis with catheters removed at the peritoneal dialysis center of the Second Hospital of Shanxi Medical University from August 2010 to May 2020.The 107 patients were divided into the open surgical extubation group and the 'pull' technique group.Sex, age, disease leading to dialysis, dialysis age, reason for extubation and preoperative test results were compared between the two groups.Operative time, length of postoperative hospitalization, perioperative pain and postoperative complications of the two groups were examined.Results:Higher levels or values were observed in operative time[(71.2±13.4)min vs.(19.3±5.6)min, t=16.933, P<0.01], length of postoperative hospitalization[(9.5±1.8)d vs.(2.2±0.5)d, t=10.988, P<0.01]and intraoperative pain score(4.4±1.6 vs.1.4±1.1, t=6.909, P<0.01)and pain score 24h after surgery(3.7±1.4 vs.0.5±0.3, t=9.995, P<0.01)in the open surgical extubation group than in the 'pull' technique group, but there was no statistical difference in the incidence of postoperative complications between the two groups(6.8% vs.5.0%, χ2=0.037, P>0.05). Conclusions:either the open surgical removal method or 'pull' technique.can safely and effectively remove the peritoneal dialysis catheter in elderly patients on peritoneal dialysis of the two methods, the 'pull' technique has advantages including less trauma, shorter and simpler surgery, helping achieve improved quality of life for elderly patients on peritoneal dialysis.
ABSTRACT
Objective:To introduce the improved "pull technique" and its preliminary application in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine.Methods:Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine has started to implement the "pull technique" since March 2018.After one patient suffered from postoperative tunnel infection, we′ve improved the operation method: after successful extubation, small incision was made at the tunnel entrance, and the skin was properly trimmed and sutured to close the tunnel entrance.Results:Until May 2020, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine has implemented the modified tube removal for 15 patients.During the follow-up period (0-25 months), there was no secondary infection or peritoneal effusion.Conclusion:For patients who meet the indications of "pull technique" , the improved "pull technique" is a trial method, which can reduce the risk of secondary infection and peritoneal effusion.