| Description: |
Background and Aims There are various techniques of peritoneal dialysis catheter insertion. Percutaneous seldinger tenckhoff catheter insertion is currently favoured and widely used because of its simple, shorter waiting time. Regardless of technique, catheter migration remains a common complication in peritoneal dialysis (PD), with the rate ranging from 5% to 60%. This will impact treatment efficacy and patient outcomes. Percutaneous seldinger tenckhoff catheter insertion with musculofascial tunnelling (MF tunnelling) during catheter insertion has been proposed as a technique to improve catheter stability, but evidence supporting its effectiveness remains limited. This study evaluates the impact of MF tunnelling on catheter migration, migration-free survival, and catheter-related complications. Method A retrospective, multicentre study was conducted at two centres. The peritoneal dialysis catheters were inserted via paramedian approach, percutaneous seldinger technique with ultrasound guidance. Patients were divided into two groups: with and without musculofascial tunnelling. Baseline characteristics, catheter migration rates, and complications were analysed. The primary outcome was catheter migration rate and 1-year migration-free survival. Secondary outcomes included catheter-related complications such as peritonitis, leaks, and bleeding. Statistical analyses were performed using Kaplan-Meier survival analysis and Cox regression modelling Results There was a total of 321 PD catheter insertion during the study period, with 247 catheters fulfilled the inclusion and exclusion criteria (134 with MF tunnelling and 113 without). The baseline characteristic showed no difference among MF-tunnelling and non-MF tunnelling group except for age (54.7 ± 14.7 vs 50.8 ± 14.9, P = 0.042), self-care pd (53.7% vs 66.4%, P = 0.044) respectively. The MF tunnelling group demonstrated significantly lower catheter migration rates (10.4%) compared to the non-MF tunnelling group (25.6%) (HR 0.396, 95% CI: 0.208–0.755, P = ... |