Does Previous Abdominal Operation Affect Peritoneal Dialysis Complications and Outcomes?
Piyatida Chuengsaman MD*, Apichat Panomrerngsak MD*, Kanda Sriudom BNS*
Affiliation : * CAPD Service and Training Center, Prommitr Branch, Banphaeo Hospital (Public Organization), Bangkok, Thailand
Objective : Peritoneal dialysis (PD) “First Policy” for end stage renal disease (ESRD) patients who are under universal
healthcare coverage scheme, was implemented in Thailand since January 2008. Now there are about 10,000 PD patients all
over the country and most of them are in low to medium socio-economic status. In the past, previous abdominal operation was
considered as a contra-indication to PD. The purpose of the present study is to compare the complications and outcomes
between patients with and without previous abdominal operation.
Material and Method: The present study was a retrospective review of all new PD cases for complications and outcome of
the first PD catheter implantation. The method of catheter implantation is mini-laparotomy under local anesthesia by one
surgeon. The bleeding, exit site/wound infection, catheter malposition/obstruction, and catheter/technique/patient survival
rate were compared between two groups.
Results : In 730 ESRD patients who underwent catheter implantation, there were 106 patients with history of previous
abdominal operation (14.5%). There were no significant differences between patients “with previous abdominal operation”
and “without previous abdominal operation”, for bleeding, exit site/wound infection, catheter malposition/obstruction, and
catheter/technique/patient survival.
Conclusion : History of previous abdominal operation in ESRD patients is not a contra-indication to PD. The complications
are low and the outcomes are excellent regardless of previous abdominal operation. Dedicated catheter implantation team
might be the key of success.
Keywords : “PD First” policy, Peritoneal dialysis, Peritoneal dialysis catheter, Previous abdominal operation, Post-operative complication, Catheter malfunction
