Journal Article

Delayed complications following Tenckhoff catheter removal.

J J Elkabir, A A Riaz, S K Agarwal and G Williams

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 14, issue 6, pages 1550-1552
Published in print June 1999 | ISSN: 0931-0509
Published online June 1999 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/14.6.1550
Delayed complications following Tenckhoff catheter removal.

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BACKGROUND: Tenckhoff catheter placement is well established to facilitate continuous ambulatory peritoneal dialysis (CAPD) in the treatment of end-stage renal failure. Complications of these catheters while in situ are well documented. However, little information is available concerning post-removal complications. Many centres, including our own remove these catheters by traction resulting in retained cuffs, rather than by formal dissection. We have evaluated the outcome of such removal over a 2-year period. METHODS: Sixty-two patients underwent Tenckhoff catheter removal by traction over a 2-year period at our unit. Patients were evaluated retrospectively using case notes and operation records. RESULTS: The catheters were sited for a mean of 23 months and were most commonly removed because of persistent peritonitis (48.4%). Sixty-one per cent of all patients had experienced at least one episode of CAPD peritonitis while the catheter was in situ, but this did not correlate with those who developed local sepsis. Fifteen patients (24.2%) subsequently developed local infective complications after a mean of 5.7 months (range 1-17 months). The subcutaneous cuff was involved in all cases and the peritoneal cuff was involved in six cases. Thirty patients were identified as being immunosuppressed, but this was not a risk factor in the development of retained cuff infections. CONCLUSIONS: There is a significant risk of local sepsis with retained cuffs resulting from removal by traction and our data suggests that these catheters should be removed by dissection and excision of both cuffs.

Journal Article.  0 words. 

Subjects: Nephrology

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