Continuous ambulatory peritoneal dialysis catheter placement: Is omentectomy necessary?

Abstract

<b>Context:</b> There are different methods of continuous ambulatory peritoneal dialysis (CAPD) catheter placement. Open surgical technique is a widely followed method. The complication rate following catheter placement varies and catheter blockage due to omental plugging is one of the main reasons. <b>Aim:</b> To analyze the need for routine omentectomy during CAPD catheter placement. <b>Materials and Methods:</b> This was a retrospective analysis of 58 CAPD catheter placements performed between July 2002 and June 2007. Tenckhoff double cuffed catheter was used in all. The postoperative complications were analyzed. <b>Results:</b> There were 44 males and 14 females. The mean age was 51 years ranging from 15 to 76 years. Of these, 40 (69&#x0025;) patients underwent omentectomy (group A) and 18 (31&#x0025;) did not (group B). Laparoscopic and open techniques were performed in 5 and 53 patients, respectively. Omentectomy was not performed in 13 patients with open technique and all the five in the laparoscopic group. One patient in group A developed hemoperitoneum which was treated conservatively. None from group A developed catheter blockage, whereas five (27.8&#x0025;) from group B developed catheter blockage postoperatively. The median time interval between the primary procedure and development of catheter blockage was 45 days (ranged from 14 to 150 days). <b>Conclusions:</b> Omentectomy during CAPD catheter placement prevents catheter blockage and secondary interventions