Laparoscopic placement of peritoneal dialysis catheter: description and results of a two-port technique
Colocación de catéter de diálisis peritoneal por laparoscopia: descripción y resultados de una técnica propia de dos puertos
Read
20200
Timeswas read the article
3231
Total PDF
16969
Total HTML
Share statistics
array:21 [ "pii" => "X2013251410035921" "issn" => "20132514" "doi" => "10.3265/Nefrologia.pre2010.Apr.10412" "estado" => "S300" "fechaPublicacion" => "2010-05-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2010;30:354-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 9515 "formatos" => array:3 [ "EPUB" => 308 "HTML" => 8520 "PDF" => 687 ] ] "Traduccion" => array:1 [ "es" => array:17 [ "pii" => "X0211699510035924" "issn" => "02116995" "doi" => "10.3265/Nefrologia.pre2010.Apr.10412" "estado" => "S300" "fechaPublicacion" => "2010-05-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia. 2010;30:354-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 63454 "formatos" => array:3 [ "EPUB" => 420 "HTML" => 61688 "PDF" => 1346 ] ] "es" => array:12 [ "idiomaDefecto" => true "titulo" => "Colocación de catéter de diálisis peritoneal por laparoscopia: descripción y resultados de una técnica propia de dos puertos" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "354" "paginaFinal" => "359" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Laparoscopic placement of peritoneal dialysis catheter: description and results of a two-port technique" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "10446_18030_4129_es_10446figura_1.jpg" "Alto" => 342 "Ancho" => 478 "Tamanyo" => 52393 ] ] "descripcion" => array:1 [ "es" => "Catéter de Oreopoulos-Zellerman con guía de Guyon de punta atraumática." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Eduard García-Cruz, M. Vera-Rivera, J.M. Corral Moro, J.M. Mallafré-Sala, A. Alcaraz" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Eduard" "apellidos" => "García-Cruz" ] 1 => array:2 [ "Iniciales" => "M." "apellidos" => "Vera-Rivera" ] 2 => array:2 [ "Iniciales" => "J.M." "apellidos" => "Corral Moro" ] 3 => array:2 [ "Iniciales" => "J.M." "apellidos" => "Mallafré-Sala" ] 4 => array:2 [ "Iniciales" => "A." "apellidos" => "Alcaraz" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "X2013251410035921" "doi" => "10.3265/Nefrologia.pre2010.Apr.10412" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251410035921?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699510035924?idApp=UINPBA000064" "url" => "/02116995/0000003000000003/v0_201502091325/X0211699510035924/v0_201502091326/es/main.assets" ] ] "itemSiguiente" => array:17 [ "pii" => "X2013251410035768" "issn" => "20132514" "doi" => "10.3265/Nefrologia.pre2010.Mar.10325" "estado" => "S300" "fechaPublicacion" => "2010-05-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2010;30:360-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5250 "formatos" => array:3 [ "EPUB" => 287 "HTML" => 4502 "PDF" => 461 ] ] "en" => array:8 [ "idiomaDefecto" => true "titulo" => "Markers of podocyte dedifferentiation in a patient with collapsing glomerulonephritis" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "360" "paginaFinal" => "366" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "MARCADORES DE DESDIFERENCIACIÓN PODOCITARIA EN PACIENTE CON GLOMERULONEFRITIS COLAPSANTE" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "10325_18030_5919_en_figure1.jpg" "Alto" => 290 "Ancho" => 384 "Tamanyo" => 200424 ] ] "descripcion" => array:1 [ "en" => "Pseudo-crescents: hypertrophy and hyperplasia of the visceral epithelium. PAS 40x." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M Dolores Redondo Pachón, Rosa Ortega Salas, Cayetana Moyano Peregrín, María López Andreu, Mario Espinosa Hernández, Ana Romera Segorbe, Alberto González Menchén, Carlos Pérez-Seoane, Fernando López Rubio, Pedro Aljama García" "autores" => array:10 [ 0 => array:2 [ "nombre" => "M Dolores" "apellidos" => "Redondo Pachón" ] 1 => array:2 [ "nombre" => "Rosa" "apellidos" => "Ortega Salas" ] 2 => array:2 [ "nombre" => "Cayetana" "apellidos" => "Moyano Peregrín" ] 3 => array:2 [ "nombre" => "María" "apellidos" => "López Andreu" ] 4 => array:2 [ "nombre" => "Mario" "apellidos" => "Espinosa Hernández" ] 5 => array:2 [ "nombre" => "Ana" "apellidos" => "Romera Segorbe" ] 6 => array:2 [ "nombre" => "Alberto" "apellidos" => "González Menchén" ] 7 => array:2 [ "nombre" => "Carlos" "apellidos" => "Pérez-Seoane" ] 8 => array:2 [ "nombre" => "Fernando" "apellidos" => "López Rubio" ] 9 => array:2 [ "nombre" => "Pedro" "apellidos" => "Aljama García" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699510035760" "doi" => "10.3265/Nefrologia.pre2010.Mar.10325" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699510035760?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251410035768?idApp=UINPBA000064" "url" => "/20132514/0000003000000003/v0_201502091603/X2013251410035768/v0_201502091604/en/main.assets" ] "itemAnterior" => array:17 [ "pii" => "X2013251410035913" "issn" => "20132514" "doi" => "10.3265/Nefrologia.pre2010.Apr.10411" "estado" => "S300" "fechaPublicacion" => "2010-05-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2010;30:349-53" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5205 "formatos" => array:3 [ "EPUB" => 291 "HTML" => 4188 "PDF" => 726 ] ] "en" => array:12 [ "idiomaDefecto" => true "titulo" => "Guidelines for automated manual infusion: a practical way of prescribing postdilution on-line haemodiafiltration" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "349" "paginaFinal" => "353" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pauta de infusión manual automatizada: una forma práctica de prescribir la hemodiafiltración on-line posdilucional" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "10445_18030_5616_en_figure1_copy1.jpg" "Alto" => 297 "Ancho" => 381 "Tamanyo" => 83263 ] ] "descripcion" => array:1 [ "en" => "Replacement volume (l) in the different study situations used." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Francisco Maduell Canals, M. Arias, J. Garro Martínez, M. Vera, N. Fontseré, X. Barros, E. Massó, M.N. Martina, A. Sentis, C. Durán, E. Bergada, A. Cases, J.M. Campistol" "autores" => array:13 [ 0 => array:2 [ "nombre" => "Francisco" "apellidos" => "Maduell Canals" ] 1 => array:2 [ "Iniciales" => "M." "apellidos" => "Arias" ] 2 => array:2 [ "Iniciales" => "J." "apellidos" => "Garro Martínez" ] 3 => array:2 [ "Iniciales" => "M." "apellidos" => "Vera" ] 4 => array:2 [ "Iniciales" => "N." "apellidos" => "Fontseré" ] 5 => array:2 [ "Iniciales" => "X." "apellidos" => "Barros" ] 6 => array:2 [ "Iniciales" => "E." "apellidos" => "Massó" ] 7 => array:2 [ "Iniciales" => "M.N." "apellidos" => "Martina" ] 8 => array:2 [ "Iniciales" => "A." "apellidos" => "Sentis" ] 9 => array:2 [ "Iniciales" => "C." "apellidos" => "Durán" ] 10 => array:2 [ "Iniciales" => "E." "apellidos" => "Bergada" ] 11 => array:2 [ "Iniciales" => "A." "apellidos" => "Cases" ] 12 => array:2 [ "Iniciales" => "J.M." "apellidos" => "Campistol" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699510035916" "doi" => "10.3265/Nefrologia.pre2010.Apr.10411" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699510035916?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251410035913?idApp=UINPBA000064" "url" => "/20132514/0000003000000003/v0_201502091603/X2013251410035913/v0_201502091604/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "titulo" => "Laparoscopic placement of peritoneal dialysis catheter: description and results of a two-port technique" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "354" "paginaFinal" => "359" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Eduard García-Cruz, M. Vera-Rivera, J.M. Corral Moro, J.M. Mallafré-Sala, A. Alcaraz" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Eduard" "apellidos" => "García-Cruz" "email" => array:1 [ 0 => "edu_garcia_cruz@yahoo.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:3 [ "Iniciales" => "M." "apellidos" => "Vera-Rivera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] 2 => array:3 [ "Iniciales" => "J.M." "apellidos" => "Corral Moro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 3 => array:3 [ "Iniciales" => "J.M." "apellidos" => "Mallafré-Sala" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 4 => array:3 [ "Iniciales" => "A." "apellidos" => "Alcaraz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Urología, Hospital Clínic de Barcelona, Barcelona, España, " "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:3 [ "entidad" => "Servicio de Urología.Institut Clínic de Nefrología i Urologia, Hospital Clínic de Barcelona, Barcelona, España, " "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Colocación de catéter de diálisis peritoneal por laparoscopia: descripción y resultados de una técnica propia de dos puertos" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "10446_18030_5908_en_figure1.jpg" "Alto" => 721 "Ancho" => 1014 "Tamanyo" => 436957 ] ] "descripcion" => array:1 [ "en" => "Oreopoulos-Zellerman catheter with Guyon guide with atraumatic tip." ] ] ] "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">INTRODUCTION </span></p><p class="elsevierStylePara"> </p><p class="elsevierStylePara">Peritoneal dialysis (PD) is a valid alternative to haemodialysis, which, in comparison, possesses some advantages. With regards to patients, PD allows for improved mobility, more dietary freedom, better haemodynamic control and less technical complexity.<span class="elsevierStyleSup">1 </span>From an economic point of view, PD has a lower cost compared with haemodialysis. In sum, PD patients have higher satisfaction than patients on haemodialysis.<span class="elsevierStyleSup">2-8 </span>On the other hand, PD has some disadvantages, most of them related to the catheter, such as catheter infection, obstruction, or migration of the catheter, cuff extrusion, incisional hernias, and fluid leaks.<span class="elsevierStyleSup">5,9-12 </span></p><p class="elsevierStylePara"> Catheter placement techniques have evolved from open surgery to minimally invasive procedures over the past two decades. In parallel, percutaneous placement of the dialysis catheters through the Seldinger technique has been used.<span class="elsevierStyleSup">13 </span>At present, catheter placement can be performed through open surgery, percutaneous insertion, or laparoscopic surgery. Open surgery is a simple procedure, which requires a minimal laparotomy, and has been the most widely used option.<span class="elsevierStyleSup">2,7,14-16 </span>However, open surgery allows a limited view, especially significant in patients with history of abdominal surgery, in which intestinal adhesions can hinder the procedure.<span class="elsevierStyleSup">17-19 </span>For this reason, the rate of obstruction of catheters placed by open surgery reaches 22%.<span class="elsevierStyleSup">3,15,16,20 </span></p><p class="elsevierStylePara"> These technical problems with open surgery led to the development of new strategies for PD catheter placement two decades ago. Laparoscopic surgery, performed mostly with three trocars, was developed at this point.<span class="elsevierStyleSup">21,22 </span>By providing an optimal view of the peritoneal cavity, and thus decreasing catheter obstruction and obstruction-related infections, the laparoscopic approach has gained wide acceptance.<span class="elsevierStyleSup">23-25 </span>Laparoscopic surgery has a number of clear benefits, especially in the reduction of postoperative pain. Less postoperative pain allows for an earlier discharge and an early normalisation of social life.<span class="elsevierStyleSup">4,26 </span>Furthermore, skilled laparoscopic surgery offers better cosmetic results. In this study we describe a new surgical technique for PD catheter placement using a laparoscopic approach with two ports. This initial experience examines viability, effectiveness, and safety. <span class="elsevierStyleBold"> </span></p><p class="elsevierStylePara"><span class="elsevierStyleBold"> </span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">MATERIAL AND METHOD </span></p><p class="elsevierStylePara"> </p><p class="elsevierStylePara">We prospectively analysed 51 consecutive patients who underwent PD catheter placement at our centre from January 2006 to July 2009. Demographic, clinical, preoperative and postoperative data were collected prospectively. <span class="elsevierStyleBold"> </span></p><p class="elsevierStylePara"><span class="elsevierStyleBold"> Demographic data </span></p><p class="elsevierStylePara"> Patients included 19 women and 32 men, mean age 56 ± 18 years. All procedures were performed under general anaesthesia. The mean body mass index was 24.5 ± 3.5kg/m<span class="elsevierStyleSup">2</span>. The average anaesthetic risk (ASA) was III (40% ASA II, 48% ASA III, 12% ASA IV). <span class="elsevierStyleBold"> </span></p><p class="elsevierStylePara"><span class="elsevierStyleBold"> Surgical technique </span></p><p class="elsevierStylePara"> Here we describe a new surgical technique using two 12mm ports for PD catheter placement; for this, a Guyon guide with atraumatic tip was used (Figure 1). After lubricating the Guyon guide, the catheter was placed over it to obtain a rigidly braced catheter. An Oreopoulos-Zellerman catheter was used.</p><p class="elsevierStylePara"> We achieved pneumoperitoneum by minimal periumbilical laparotomy and a 12mm trocar was placed. Under direct visualisation, a left pararectus 12mm trocar was placed. The optics were placed through this trocar and the catheter with the guide was placed through the periumbilical trocar. Then, the tip of the catheter was situated in the pouch of Douglas and the Guyon guide was removed. Proper catheter position was checked visually, after which the two trocars could be removed. A subcutaneous tunnel was created between the two trocars and the catheter is exteriorised through the left pararectus trocar hole (Figure 2). <span class="elsevierStyleBold"> </span></p><p class="elsevierStylePara"><span class="elsevierStyleBold"> </span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">RESULTS </span></p><p class="elsevierStylePara"> </p><p class="elsevierStylePara">All procedures were completed laparoscopically with two 12mm ports. Mean operative time was 32 minutes (range: 15-55 minutes). One patient had catheter obstruction in the first 24 hours after placement and required surgical revision and relocation. No other complications occurred during the intraoperative or immediate postoperative period. Mean</p><p class="elsevierStylePara"> follow-up was 25 months. The average stay was 1.02 ± 2.2 days. Approximately twothirds of patients (65%) were discharged on the day of surgery, and up to 80% within the first 24 hours postoperatively. Patients who remained in the hospital after 24 hours of the procedure did so for medical problems unrelated to the procedure.</p><p class="elsevierStylePara"> There were no leakages of peritoneal fluid or surgical wound infections during the immediate postoperative period (< 48 h). There were no cuff extrusions or eventrations. The catheter obstruction rate was 7.8%, and catheter migration rate was 4% (2 patients). One of these patients required catheter removal due to severe peritonitis. In the other case, the catheter did not result in obstruction or peritonitis, and worked correctly.</p><p class="elsevierStylePara"> A total of three patients died, an average of 16 months after catheter placement (2.35 deaths per 1,000 patient/month of exposure). The causes of death were cardiovascular complications secondary to end-stage renal disease. Mortality was not related to PD or to the catheter. The survival curves of patients on PD are shown in Figure 3, and the survival curve of the catheters in Figure 4. A total of three catheters (5.9%) had to be removed due to peritonitis, all working properly. According to our experience, we had 0.27 episodes of peritonitis per patient/year.</p><p class="elsevierStylePara"> Two catheters were removed because of technical complications in the postoperative period. In the first case, the patient developed abdominal pain that required exploratory laparotomy and it appeared that the catheter was lying in a loop of intestine. After verifying that the bowel loop was viable, the catheter was removed and a new one placed. The patient is currently in the PD program. The second patient, nine months after surgery, presented with canalisation of a peritoneum-vaginal tract and developed a hydrocele. The patient refused surgical correction and was transferred to the haemodialysis programme. <span class="elsevierStyleBold"> </span></p><p class="elsevierStylePara"><span class="elsevierStyleBold"> </span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">DISCUSSION </span></p><p class="elsevierStylePara"> </p><p class="elsevierStylePara">PD is a safe and effective option for patients with end-stage renal disease. Furthermore, there is evidence of better preservation of residual renal function when compared with haemodialysis.<span class="elsevierStyleSup">27,28 </span>Although open surgery has been the method of choice, the laparoscopic approach has been widely accepted.<span class="elsevierStyleSup">29-31 </span></p><p class="elsevierStylePara"> Our technique, described above, is a simple procedure through two 12mm trocars. Furthermore, it is a very fast procedure, with a short operative time. Regarding the intraoperative advantages, laparoscopy allows for optimal visualisation and evaluation of the peritoneal cavity, allowing precise catheter placement. Furthermore, laparoscopy allows for release of peritoneal adhesions if necessary.</p><p class="elsevierStylePara"> The use of a Guyon guide has been very helpful for accurate placement of the catheter, as the atraumatic tip and rigidity make it possible to both guide the catheter to the pouch of Douglas and reposition it if necessary. The incidence of catheter obstruction in the literature varies between 10% and 22% in open surgical procedures with blind placement. On the other hand, laparoscopic surgery has much lower obstruction rates of between 4% and 13%. Based on our experience, the obstruction rate was 3.9%. Despite this low rate, we must bear in mind our limited follow-up. Peritoneal leakage rates range from 2.6% to 22%. In our experience, we have not had any leakage. This complication is not only associated with open surgery, but also with the laparoscopic approach. Paramedial placement and the creation of a long subcutaneous tunnel are strategies for attempting to reduce this complication<span class="elsevierStyleSup">32,33 </span>and may explain the absence of fistula in our series.</p><p class="elsevierStylePara"> In analysing our technique compared to other three-port laparoscopic techniques, our experience is comparable in terms of surgical time, hospitalisation time, and catheter obstruction rate.<span class="elsevierStyleSup">30,34,35 </span>The rates of peritoneal fluid fistula with three-port techniques vary between 0% and 4.7%. Accepting our limited follow-up, our results are at least equal.<span class="elsevierStyleSup">25,30 </span>We have had no cases of surgical wound infection. It could be argued that a short operating time is important to limiting wound infections, but other centres with similar surgical times report port infection rates of up to 21%.<span class="elsevierStyleSup">35 </span></p><p class="elsevierStylePara"> We did not have peritonitis in the early postoperative period (first two weeks) after implantation of the catheter but we did have one episode of peritonitis per patient every 32.4 months (0.27 episodes per patient year), which is lower than suggested in the literature.<span class="elsevierStyleSup">36 </span>More follow-up is needed to determine the risk of peritonitis associated with our technique.</p><p class="elsevierStylePara"> In short, we believe that our technique is a simple and rapid procedure with few complications and short hospitalisation time, due to its reliability and excellent results in terms of catheter function.  </p><p class="elsevierStylePara"><a href="grande/10446_18030_5908_en_figure1.jpg" class="elsevierStyleCrossRefs"><img src="10446_18030_5908_en_figure1.jpg" alt="Oreopoulos-Zellerman catheter with Guyon guide with atraumatic tip."></img></a></p><p class="elsevierStylePara">Figure 1. Oreopoulos-Zellerman catheter with Guyon guide with atraumatic tip.</p><p class="elsevierStylePara"><a href="grande/10446_18030_5909_en_figure2.jpg" class="elsevierStyleCrossRefs"><img src="10446_18030_5909_en_figure2.jpg" alt="Position of ports. Periumbilical 12mm port for the catheter and left pararectus port with 12mm optics."></img></a></p><p class="elsevierStylePara">Figure 2. Position of ports. Periumbilical 12mm port for the catheter and left pararectus port with 12mm optics.</p><p class="elsevierStylePara"><a href="grande/10446_18030_5910_en_figure3.jpg" class="elsevierStyleCrossRefs"><img src="10446_18030_5910_en_figure3.jpg" alt="KM curve showing the survival of peritoneal dialysis patients."></img></a></p><p class="elsevierStylePara">Figure 3. KM curve showing the survival of peritoneal dialysis patients.</p><p class="elsevierStylePara"><a href="grande/10446_18030_5911_en_figure4.jpg" class="elsevierStyleCrossRefs"><img src="10446_18030_5911_en_figure4.jpg" alt="Catheters removed or replaced due to technical problems (obstruction, peritonitis or migration)."></img></a></p><p class="elsevierStylePara">Figure 4. Catheters removed or replaced due to technical problems (obstruction, peritonitis or migration).</p><p class="elsevierStylePara"><a href="grande/10446_18030_5912_en_table1.jpg" class="elsevierStyleCrossRefs"><img src="10446_18030_5912_en_table1.gif" alt="Patients excluded from the CAPD programme. Cause of exclusion, time since start, current treatment, and catheter status at time of exclusion"></img></a></p><p class="elsevierStylePara">Table 1. Patients excluded from the CAPD programme. Cause of exclusion, time since start, current treatment, and catheter status at time of exclusion</p>" "pdfFichero" => "P1-E46-S1862-A10446-EN.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:3 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec437229" "palabras" => array:1 [ 0 => "Técnica quirúrgica" ] ] 1 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec437231" "palabras" => array:1 [ 0 => "Diálisis peritoneal" ] ] 2 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec437233" "palabras" => array:1 [ 0 => "Laparoscopia" ] ] ] "en" => array:3 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec437230" "palabras" => array:1 [ 0 => "Surgical technique" ] ] 1 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec437232" "palabras" => array:1 [ 0 => "Peritoneal dialysis" ] ] 2 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec437234" "palabras" => array:1 [ 0 => "Laparoscopy" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">Aim: </span>To test the feasibility, efficacy and safety of a new  two port laparoscopic technique for dialysis catheter  placement. <span class="elsevierStyleBold">Material and methods: </span>From January 2006  to July 2009 51 patients underwent dialysis catheter  placing using an original technique. All procedures  were finished laparoscopically using two 12 mm-sized  ports. Our technique bases on placing Oreopoulos-  Zellerman catheter along a straight Guyon´s guide  with atraumatic tip, visually guaranting optimal placement.  Catheter can be repositioned if desired by reentering  the guide. Median follow-up was 25 months. <span class="elsevierStyleBold">Results:  </span>Mean operating time was 32 minutes (range  15-55 minutes). One patient suffered an immediate  postoperative catheter obstruction that required surgical  repositioning. No other technical intra or early  postoperative complications related to technique were  reported. Mean time to discharge 1,02 ± 2.2 days.  Catheter outflow failure rate was 7.6%. Conversion to  haemodialysis due to peritonitis 13%. Peritonitis per  patient/year was 0.27. Catheter 6 mo, 1 year and 2 year  survival rate was 94%, 87% and 72%. Catheter migration  rate was 4%. There was no peritoneal dialysis liquid  leakage. <span class="elsevierStyleBold">Conclusions: </span>The two ports technique described  is an easy and rapid procedure, with few complications  and early discharge. Due to its reliability, offers  good catheter function outcome. </p>" ] "es" => array:1 [ "resumen" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">Objetivo: </span>Estudiar la viabilidad, la eficacia y la seguridad<span class="elsevierStyleSup"> </span>de nuestra técnica de dos puertos de colocación de catéter<span class="elsevierStyleSup"> </span>de diálisis peritoneal por laparoscopia. <span class="elsevierStyleBold">Material y métodos:</span><span class="elsevierStyleSup"> </span>Desde enero de 2006 a julio de 2009, 51 pacientes fueron<span class="elsevierStyleSup"> </span>sometidos a colocación de catéter de diálisis peritoneal<span class="elsevierStyleSup"> </span>usando una nueva técnica. Todos los procedimientos se<span class="elsevierStyleSup"> </span>completaron laparoscópicamente usando dos puertos de<span class="elsevierStyleSup"> </span>12 mm. Nuestra técnica se basa en la colocación de un<span class="elsevierStyleSup"> </span>catéter de tipo Oreopoulos-Zellerman sobre una guía de<span class="elsevierStyleSup"> </span>Guyon recta con punta atraumática, y garantiza la óptima<span class="elsevierStyleSup"> </span>colocación del catéter. En caso necesario, éste se puede<span class="elsevierStyleSup"> </span>poner de nuevo mediante la recolocación de la guía. El<span class="elsevierStyleSup"> </span>seguimiento medio ha sido de 25 meses. <span class="elsevierStyleBold">Resultados:</span><span class="elsevierStyleSup"> </span>Tiempo quirúrgico medio: 32 minutos (rango 15-55 minutos).<span class="elsevierStyleSup"> </span>Un paciente presentó una obstrucción del catéter<span class="elsevierStyleSup"> </span>en el postoperatorio inmediato, que requirió recolocación<span class="elsevierStyleSup"> </span>quirúrgica. No se han producido otras complicaciones<span class="elsevierStyleSup"> </span>técnicas durante la cirugía o el postoperatorio inmediato.<span class="elsevierStyleSup"> </span>Media de tiempo al alta: 1,02 ± 2,2 días. Tasa de<span class="elsevierStyleSup"> </span>obstrucción del catéter: 7,6%. Tasa de conversión a<span class="elsevierStyleSup"> </span>hemodiálisis secundaria a peritonitis: 13%. Episodios de<span class="elsevierStyleSup"> </span>peritonitis por paciente-año: 0,27. Supervivencia del<span class="elsevierStyleSup"> </span>catéter a los 6 meses, un año y 5 años: 94, 87 y 72%,<span class="elsevierStyleSup"> </span>respectivamente. Tasa de migración de catéter: 4%. No se<span class="elsevierStyleSup"> </span>han comentado casos de fístula de líquido peritoneal.<span class="elsevierStyleSup"> </span><span class="elsevierStyleBold">Conclusiones: </span>La técnica de dos puertos descrita es un<span class="elsevierStyleSup"> </span>procedimiento sencillo y rápido, con pocas complicaciones y<span class="elsevierStyleSup"> </span>alta hospitalaria inmediata. Debido a su fiabilidad, ofrece<span class="elsevierStyleSup"> </span>buenos resultados en la función del catéter.<span class="elsevierStyleSup"> </span></p>" ] ] "multimedia" => array:5 [ 0 => array:8 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "10446_18030_5908_en_figure1.jpg" "Alto" => 721 "Ancho" => 1014 "Tamanyo" => 436957 ] ] "descripcion" => array:1 [ "en" => "Oreopoulos-Zellerman catheter with Guyon guide with atraumatic tip." ] ] 1 => array:8 [ "identificador" => "fig2" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "10446_18030_5909_en_figure2.jpg" "Alto" => 724 "Ancho" => 1019 "Tamanyo" => 472825 ] ] "descripcion" => array:1 [ "en" => "Position of ports. Periumbilical 12mm port for the catheter and left pararectus port with 12mm optics." ] ] 2 => array:8 [ "identificador" => "fig3" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "10446_18030_5910_en_figure3.jpg" "Alto" => 425 "Ancho" => 380 "Tamanyo" => 74061 ] ] "descripcion" => array:1 [ "en" => "KM curve showing the survival of peritoneal dialysis patients." ] ] 3 => array:8 [ "identificador" => "fig4" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "10446_18030_5911_en_figure4.jpg" "Alto" => 484 "Ancho" => 380 "Tamanyo" => 78826 ] ] "descripcion" => array:1 [ "en" => "Catheters removed or replaced due to technical problems (obstruction, peritonitis or migration)." ] ] 4 => array:7 [ "identificador" => "tbl1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "10446_18030_5912_en_table1.jpg" "imagenAlto" => 403 "imagenAncho" => 792 "imagenTamanyo" => 243294 ] ] ] ] ] "descripcion" => array:1 [ "en" => "Patients excluded from the CAPD programme. Cause of exclusion, time since start, current treatment, and catheter status at time of exclusion" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:35 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Jameson MD, Wiegmann TB. Principles, uses, and complications of hemodialysis. Med Clin North Am 1990;74:945-60. <a href="http://www.ncbi.nlm.nih.gov/pubmed/2195264" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Bullmaster JR, Miller SF, Finley RK, Jones LM. Surgical aspects of the Tenckhoff peritoneal dialysis catheter. A 7 year experience. Am J Surg 1985;149:339-42. <a href="http://www.ncbi.nlm.nih.gov/pubmed/3156518" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Cronen PW, Moss JP, Simpson T, Rao M, Cowles L. Tenckhoff catheter placement: surgical aspects. Am Surg 1985;51:627-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/4062056" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Jwo SC, Chen KS, Lin YY. Video-assisted laparoscopic procedures in peritoneal dialysis. Surg Endosc 2003;17(10):1666-70. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12915976" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Lee H, Manns B, Taub K, Ghali WA, Dean S, Johnson D, Donaldson C. Cost analysis of ongoing care of patients with end-stage renal disease: the impact of dialysis modality and dialysis access. Am J Kidney Dis 2002;40:611-22. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12200814" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Nijhuis PHA, Smulders JF, Jakimowicz JJ. Laparoscopic introduction of a continuous ambulatory peritoneal dialysis (CAPD) catheter by a two-puncture technique. Surg Endosc 1996;10:676-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/8662414" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Robison RJ, Leapman SB, Wetherington GM, Hamburger RJ, Fineberg NS, Filo RS. Surgical considerations in continuous ambulatory peritoneal dialysis. Surgery 1984;96:723-30. <a href="http://www.ncbi.nlm.nih.gov/pubmed/6385317" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Tenckhoff H, Schechter H. A bacteriological safe peritoneal access device. ASAIO Trans 1968;14:181-7." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Fleisher AG, Kimmelstiel FM, Lattes CG, Miller RE. Surgical complications of peritoneal dialysis catheters. Am J Surg 1985;149:726-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/4014548" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "James LW, Kelly R. Acute abdominal emergencies in patients on longterm ambulatory peritoneal dialysis. Can J Surg 1993;36:522-4. <a href="http://www.ncbi.nlm.nih.gov/pubmed/8258131" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Kopecky RT, Funk MM, Kreitzer PR. Localized genital edema in patients undergoing continuous ambulatory peritoneal dialysis. J Urol 1985;134:880-4. <a href="http://www.ncbi.nlm.nih.gov/pubmed/4057370" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Swartz RD. Chronic peritoneal dialysis: mechanical and infectious complications. Nephron 1985;40:29-37. <a href="http://www.ncbi.nlm.nih.gov/pubmed/4000335" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Borazan A, Comert M, Ucan BH, Comert FB, Sert M, Sekitmez N, Cesur A. The comparison in terms of early complications of a new technique and percutaneous method for the placement of CAPD catheters. Ren Fail 2006;28:37-42. <a href="http://www.ncbi.nlm.nih.gov/pubmed/16526317" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Blessing WD Jr, Ross JM, Kennedy CI, Richardson WS. Laparoscopicassisted peritoneal dialysis catheter placement, an improvement on the single trocar technique. Am Surg 2005;71:1042-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/16447476" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Crabtree JH, Fishman A. Videolaparoscopic implantation of longterm peritoneal dialysis catheters. Surg Endosc 1999;13:186-90. <a href="http://www.ncbi.nlm.nih.gov/pubmed/9918628" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Crabtree JH, Fishman A. A laparoscopic approach under local anesthesia for peritoneal dialysis access. Perit Dial Int 2000;20:757- 65. <a href="http://www.ncbi.nlm.nih.gov/pubmed/11216571" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "García Falcón T, Rodríguez-Carmona A, Pérez Fontán M, Fernández Rivera C, Bouza P, Rodríguez Lozano I, et al. Complications of permanent catheter implantation for peritoneal dialysis: incidence and risk factors. Adv Perit Dial 1994;10:206-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/7999829" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Sanderson MC, Swartzendruber DJ, Fenoglio ME, Moore JT, Haun WE. Surgical complications of continuous ambulatory peritoneal dialysis. Am J Surg 1990;16:561-6. " "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Yeh TJ, Wei CF, Chin TW. Catheter-related complications of continuous ambulatory peritoneal dialysis. Eur J Surg 1992;158:277- 9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/1354492" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Olcott C, Feldman CA, Coplon NS, Oppenheimer ML, Mehigan JT. Continuous ambulatory peritoneal dialysis: technique of catheter insertion and management of associated surgical complications. Am J Surg 1983;146:98-102. <a href="http://www.ncbi.nlm.nih.gov/pubmed/6869687" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Ash SR, Wolf R. Placement of the Tenckhoff peritoneal dialysis catheter under peritoneoscopic visualization. Dial Transplant 1981;10:383-6." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Copley JB, Lindberg JS, Back SN, Tapia NP. Peritoneoscopic placement of swan neck peritoneal dialysis catheters. Perit Dial Int 1996;16:S330-2. <a href="http://www.ncbi.nlm.nih.gov/pubmed/8728218" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Kriger FL, Montenegro J, Amerling R, Cruz C. Use of a single delivery system for peritoneal dialysis: results of a multicenter trial. J Am Soc Nephrol 1991;2:364." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Nahman NS Jr, Middendorf DF, Bay WH, McElligot R, Powell S, Anderson J. Modification of the percutaneous approach to peritoneal dialysis catheter placement under peritoneoscopic visualization: clinical results in 78 patients. J Am Soc Nephrol 1992;3:103-7. <a href="http://www.ncbi.nlm.nih.gov/pubmed/1391701" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Pastan S, Gassensmith C, Manatunga AK, Copley JB, Smith EJ, Hamburger RJ. Prospective comparison of peritoneoscopic and surgical implantation of CAPD catheters. ASAIO Trans 1991;37(3):M154-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/1836333" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Tsimoyiannis EC, Siakas P, Glantzounis G, Toli C, Sferopoulos G, Pappas M, et al. Laparoscopic placement of the Tenckhoff catheter for peritoneal dialysis. Surg Laparosc Endosc Percutan Tech 2000;10:218-21. <a href="http://www.ncbi.nlm.nih.gov/pubmed/10961749" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 26 => array:3 [ "identificador" => "bib27" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Heaf JG, Lokkegaard H, Madsen M. Initial survival advantage of peritoneal dialysis relative to haemodialysis. Nephrol Dial Transpl 2002;17:112-7." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 27 => array:3 [ "identificador" => "bib28" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Collins AJ, Hao W, Xia H, Ebben JP, Everson SE, Constantini EG, et al. Mortality risks of peritoneal dialysis and hemodialysis. Am J Kidney Dis 1999;34:1065-74. <a href="http://www.ncbi.nlm.nih.gov/pubmed/10585316" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 28 => array:3 [ "identificador" => "bib29" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Evangelos CT, Siakis P, Glantzounis G, Toli C, Sferopoulos G, Pappas M, Pappas M. Laparoscopic placement of the Tenckhoff catheter for peritoneal dialysis. Surg Laparosc Endosc Percutan Tech 2000;10:218-21. <a href="http://www.ncbi.nlm.nih.gov/pubmed/10961749" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 29 => array:3 [ "identificador" => "bib30" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Comert M, Borazan A, Kulah E, Ucan BH. A new laparoscopic technique for the placement of a permanent peritoneal dialysis catheter: The preperitoneal tunneling method. Surg Endosc 2005;19:245-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/15529192" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 30 => array:3 [ "identificador" => "bib31" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Crabtree JH, Fishman A. A laparoscopic method for optimal peritoneal dialysis access. Am Surg 2005;71:135-43. 32. Borazan A, Comert M, Ucan BH, Comert FB, Sert M, Sekitmez N, et al. The comparison in terms of early complications of a new technique and percutaneous method for the placement of CAPD catheters. Ren Fail 2006;28:37-42. " "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 31 => array:3 [ "identificador" => "bib32" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Hwang TL, Chen MF, Wu CH, Leu ML, Huang CC. Comparison for four techniques of catheter insertion in patients undergoing continuous ambulatory peritoneal dialysis. Eur J Surg 1995;161:401-4. <a href="http://www.ncbi.nlm.nih.gov/pubmed/7548375" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 32 => array:3 [ "identificador" => "bib33" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Soontrapornchai P, Simapatanapong T. Comparison of open and laparoscopic secure placement of peritoneal dialysis catheters. Surg Endosc 2005;19:137-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/15549631" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 33 => array:3 [ "identificador" => "bib34" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Ögunç G, Tuncer M, Ögunç D, Yardimsever M, Ersoy F. Laparoscopic omental fixation technique vs open surgical placement of peritoneal dialysis catheters. A prospective study on outcome. Surg Endosc 2003;17:1749-55. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12811666" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 34 => array:3 [ "identificador" => "bib35" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Álvarez-Ude F, Arenas D, Arrieta L, Bajo MA, Borrás M, Coronel F, et al. Plan de calidad científico-técnica y de mejora continua de calidad en diálisis peritoneal. Grupo de promoción del conocimiento en diálisis peritoneal. Sociedad Española de Nefrología; 2007. http://www.senefro.org/modules/subsection/files/calidad_dp__sen_ 2007.pd \u{A0}" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003000000003/v0_201502091603/X2013251410035921/v0_201502091604/en/main.assets" "Apartado" => array:4 [ "identificador" => "35448" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Technical Notes" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003000000003/v0_201502091603/X2013251410035921/v0_201502091604/en/P1-E46-S1862-A10446-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251410035921?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 6 | 5 | 11 |
| 2024 October | 87 | 54 | 141 |
| 2024 September | 104 | 63 | 167 |
| 2024 August | 117 | 88 | 205 |
| 2024 July | 90 | 39 | 129 |
| 2024 June | 124 | 78 | 202 |
| 2024 May | 147 | 52 | 199 |
| 2024 April | 101 | 58 | 159 |
| 2024 March | 130 | 26 | 156 |
| 2024 February | 84 | 37 | 121 |
| 2024 January | 102 | 24 | 126 |
| 2023 December | 104 | 47 | 151 |
| 2023 November | 197 | 66 | 263 |
| 2023 October | 212 | 83 | 295 |
| 2023 September | 135 | 72 | 207 |
| 2023 August | 157 | 50 | 207 |
| 2023 July | 180 | 57 | 237 |
| 2023 June | 123 | 52 | 175 |
| 2023 May | 213 | 82 | 295 |
| 2023 April | 124 | 47 | 171 |
| 2023 March | 147 | 54 | 201 |
| 2023 February | 98 | 37 | 135 |
| 2023 January | 141 | 40 | 181 |
| 2022 December | 141 | 42 | 183 |
| 2022 November | 174 | 49 | 223 |
| 2022 October | 199 | 66 | 265 |
| 2022 September | 151 | 49 | 200 |
| 2022 August | 153 | 51 | 204 |
| 2022 July | 128 | 56 | 184 |
| 2022 June | 168 | 55 | 223 |
| 2022 May | 190 | 41 | 231 |
| 2022 April | 167 | 71 | 238 |
| 2022 March | 173 | 66 | 239 |
| 2022 February | 191 | 53 | 244 |
| 2022 January | 180 | 36 | 216 |
| 2021 December | 155 | 52 | 207 |
| 2021 November | 173 | 47 | 220 |
| 2021 October | 163 | 81 | 244 |
| 2021 September | 164 | 38 | 202 |
| 2021 August | 275 | 41 | 316 |
| 2021 July | 229 | 49 | 278 |
| 2021 June | 175 | 34 | 209 |
| 2021 May | 188 | 37 | 225 |
| 2021 April | 364 | 75 | 439 |
| 2021 March | 250 | 29 | 279 |
| 2021 February | 155 | 28 | 183 |
| 2021 January | 134 | 33 | 167 |
| 2020 December | 99 | 19 | 118 |
| 2020 November | 99 | 17 | 116 |
| 2020 October | 103 | 8 | 111 |
| 2020 September | 93 | 12 | 105 |
| 2020 August | 97 | 6 | 103 |
| 2020 July | 132 | 13 | 145 |
| 2020 June | 110 | 9 | 119 |
| 2020 May | 94 | 18 | 112 |
| 2020 April | 99 | 25 | 124 |
| 2020 March | 113 | 19 | 132 |
| 2020 February | 116 | 20 | 136 |
| 2020 January | 94 | 23 | 117 |
| 2019 December | 136 | 21 | 157 |
| 2019 November | 80 | 23 | 103 |
| 2019 October | 91 | 11 | 102 |
| 2019 September | 142 | 29 | 171 |
| 2019 August | 111 | 19 | 130 |
| 2019 July | 114 | 22 | 136 |
| 2019 June | 111 | 18 | 129 |
| 2019 May | 135 | 29 | 164 |
| 2019 April | 153 | 41 | 194 |
| 2019 March | 85 | 26 | 111 |
| 2019 February | 56 | 24 | 80 |
| 2019 January | 54 | 22 | 76 |
| 2018 December | 216 | 31 | 247 |
| 2018 November | 279 | 21 | 300 |
| 2018 October | 239 | 29 | 268 |
| 2018 September | 192 | 12 | 204 |
| 2018 August | 155 | 11 | 166 |
| 2018 July | 152 | 20 | 172 |
| 2018 June | 93 | 15 | 108 |
| 2018 May | 106 | 11 | 117 |
| 2018 April | 125 | 13 | 138 |
| 2018 March | 105 | 10 | 115 |
| 2018 February | 95 | 5 | 100 |
| 2018 January | 96 | 11 | 107 |
| 2017 December | 116 | 7 | 123 |
| 2017 November | 95 | 9 | 104 |
| 2017 October | 84 | 7 | 91 |
| 2017 September | 105 | 14 | 119 |
| 2017 August | 143 | 8 | 151 |
| 2017 July | 163 | 12 | 175 |
| 2017 June | 196 | 12 | 208 |
| 2017 May | 195 | 12 | 207 |
| 2017 April | 107 | 9 | 116 |
| 2017 March | 193 | 9 | 202 |
| 2017 February | 188 | 13 | 201 |
| 2017 January | 135 | 13 | 148 |
| 2016 December | 114 | 7 | 121 |
| 2016 November | 179 | 15 | 194 |
| 2016 October | 253 | 10 | 263 |
| 2016 September | 477 | 4 | 481 |
| 2016 August | 515 | 8 | 523 |
| 2016 July | 257 | 9 | 266 |
| 2016 June | 175 | 0 | 175 |
| 2016 May | 191 | 0 | 191 |
| 2016 April | 160 | 0 | 160 |
| 2016 March | 131 | 0 | 131 |
| 2016 February | 137 | 0 | 137 |
| 2016 January | 148 | 0 | 148 |
| 2015 December | 151 | 0 | 151 |
| 2015 November | 104 | 0 | 104 |
| 2015 October | 100 | 0 | 100 |
| 2015 September | 105 | 0 | 105 |
| 2015 August | 98 | 0 | 98 |
| 2015 July | 100 | 0 | 100 |
| 2015 June | 49 | 0 | 49 |
| 2015 May | 61 | 0 | 61 |
| 2015 April | 11 | 0 | 11 |
Show all
