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Journal of the Korean Society of Pediatric Nephrology 2007;11(1): 51-58. doi: https://doi.org/10.3339/jkspn.2007.11.1.51
소아에서 복막투석도관 삽입시 복강경을 이용한 방법과 기존의 수술법에 따른 초기 합병증 발생의 차이
정수인, 이현영, 이철구, 서정민, 이석구, 김수진, 곽민정, 진동규, 백경훈
1성균의대 삼성서울병원 소아과학교실
2성균의대 삼성서울병원 소아과학교실
3성균의대 삼성서울병원 외과학교실
4성균의대 삼성서울병원 외과학교실
5성균의대 삼성서울병원 외과학교실
6성균의대 삼성서울병원 소아과학교실
7성균의대 삼성서울병원 소아과학교실
8성균의대 삼성서울병원 소아과학교실
9성균의대 삼성서울병원 소아과학교실
Comparison of Early Complications after Peritoneal Dialysis Catheter Implantation by Laparoscopic Surgery and Conventional Surgery in Children
Soo-In Jeong, Hyun-Young Lee, Cheol-Gu Lee, Jeong-Meen Seo, Suk-Koo Lee, Su-Jin Kim, Min-Jung Kwak, Dong-Kyu Jin, Kyung-Hoon Paik
1Departments of Pediatrics, Samsung Medical Center, School of Medicine Sungkyunkwan University
2Departments of Pediatrics, Samsung Medical Center, School of Medicine Sungkyunkwan University
3Departments of Surgery, Samsung Medical Center, School of Medicine Sungkyunkwan University
4Departments of Surgery, Samsung Medical Center, School of Medicine Sungkyunkwan University
5Departments of Surgery, Samsung Medical Center, School of Medicine Sungkyunkwan University
6Departments of Pediatrics, Samsung Medical Center, School of Medicine Sungkyunkwan University
7Departments of Pediatrics, Samsung Medical Center, School of Medicine Sungkyunkwan University
8Departments of Pediatrics, Samsung Medical Center, School of Medicine Sungkyunkwan University
9Departments of Pediatrics, Samsung Medical Center, School of Medicine Sungkyunkwan University
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ABSTRACT
Purpose : To assess the early complication of laparoscopic peritoneal dialysis catheter implantation in children.
Methods : Medical record review was carried out on 21 laparoscopic and 16 conventional peritoneal dialysis catheter implantations which were performed in 31 children under 18 years of age between 2002 and 2006. All medical records were retrospectively analyzed. The patients were followed until 2 months after catheter placement. Patient characteristics and catheterrelated complications, such as significant bleeding, leakage, obstruction, migration, insertion site infection and peritonitis during the first 60 days after implantation were recorded.
Results : After conventional operation, dialysate leakage occurred in 2 of 16 cases and all cases improved after conservative management. In 1 case, significant bleeding occurred and re-operation was performed. Three cases of obstruction due to migration were reported, 2 cases underwent reoperation and 1 case improved without intervention. After laparoscopic surgery, outflow obstruction occurred in 1 out of 21 cases, which was caused by adhesion after several reinsertions of the catheter and recurrent peritonitis. No migration was noted after laparoscopic surgery. There was no significant difference in the complication rate between the two groups.
Conclusion : Laparoscopic peritoneal dialysis catheter placement is feasible in children of all age groups, with at least equivalent functional results compared to conventional surgery. The additional advantage of laparoscopic catheter insertion is the option to identify and eliminate anatomical risk factors, such as intra-abdominal adhesions, and to perform partial omentectomy without additional incisions.
Key words: Laparoscopy | Early complication | Peritoneal dialysis catheter | Children
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