The Effects of Peritoneal Dialysis Catheter Insertion Using Paramedian Versus Midline Approach on Children

• Main Authors: Masoud Jamshidi, Davoud Badebarin, Amir Asadloo, Sara Akhavan Salamat, Seyed Ehsan Mousavi Toomatari
• Format: Article
• Language: English
• Published: KARE Publishing 2020-04-01
• Series: Erciyes Medical Journal
• Subjects: peritoneal dialysis; catheter insertion; para-median; midline.
• Online Access: https://jag.journalagent.com/z4/download_fulltext.asp?pdir=erciyesmedj&un=EMJ-71463

Objective: There are several methods for dialysis in children with chronic renal failure. One of the methods is the insertion of a peritoneal dialysis (PD) catheter, which can be embedded with para-median and midline approaches. In this study, we aim to compare the complications and the success rate of these two approaches. Materials and Methods: In this retrospective study, 41 patients under seven years who had undergone PD due to renal failure were included in this study. PD catheter was inserted via the paramedian approach in 15 and midline approach in 26 cases. Any early or late complications, as well as success rate, were compared between two approaches. Results: Paramedian compared to midline approach had a significantly lower rate of catheter obstruction (20% vs. 53.8%, p=0.03), leakage (13.3% vs. 46.2%, p=0.03) and local infection (13.3% vs. 50%, p=0.02) from early complications and lower rate of late fluid leakage (13.3% vs. 46.2%, p=0.03) and tunnel or exit site infection (6.7% vs. 38.5%, p=0.02) from late complications. The paramedian approach had a significantly higher rate of success (80% vs. 42.3%, p=0.02). Conclusion: Paramedian is a better approach for PD catheter insertion due to lower early and late complications, as well as a higher success rate.