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Preliminary report: cystoscopy-assisted peritoneal dialysis catheter placement - a direct, visual, safe, precise, easy, minimally invasive, and inexpensive technique.

OBJECTIVE
We introduce a new method of peritoneal dialysis (PD) catheter placement with cystoscopic assistance. It has clear advantages compared with conventional open surgery.


MATERIALS AND METHODS
Patients with end-stage renal disease (ESRD) were randomly divided into two groups. Group A (14 patients) underwent cystoscopy-assisted surgery, and group B (15 patients) underwent conventional open surgery for the PD catheter placement. Continuous ambulatory PD training was started 14 days after surgery in both groups. We evaluated the differences between the two groups prospectively.


RESULTS
Both groups had no difference in demographics including age, male/female ratio, previous abdominal surgery percent, and cause of ESRD (p > 0.05). All catheters were placed successfully without mortality. Group A had better surgery-related data: local anesthesia rate, VAS (Visual Analogue Score), incisional length, and hospital stay were significantly different compared with group B (p < 0.05). And the blood loss duration surgery and duration of surgery were not significantly different (p > 0.05). In group A, there was no case of catheter obstruction and migration, dialysate leak, exit site infection, or incisional hernia. There was only one peritonitis case in group A. Compared with group B, the total surgical complications difference was significant (p < 0.05).


CONCLUSION
Cystoscopy-assisted PD catheter placement is a direct, visual, safe, precise, easy, inexpensive, and minimally invasive technique that is ideal for patients with ESRD.