Laparoscopic interventions in children on peritoneal dialysis

Abstract

Introduction: The benefits of peritoneal dialysis (PD) are multiple. However, it is connected with the risk of numerous complications, both infectious and non-infectious. Laparoscopic interventions in children on PD have seldom been presented. Aim: To analyse laparoscopic interventions in 23 children (mean age 10.2 ±5.2 years) treated with PD. Methods: Performed procedures (30) included: diagnostic (explorative) laparoscopy, laparoscopic replacement of the catheter and laparoscopic recanalisation of occluded catheter. Results: In 29 cases laparoscopy with reduced invasive procedures was completed. During surgery 5 catheters were removed. In 16 cases of catheter malfunction, omental wrap releasing, recanalization and/or reposition was done, including omentectomy in 9 cases. In 6 cases of acute abdomen symptoms, 3 adhesiolysis procedures in bowel obstruction, 2 appendectomies and in 1 case laparoscopic reduction of intussusception were done. There were no intraoperative complications. After surgery PD was continued in 19 children. Catheter survival rate was 261 ±297 days. Laparoscopic surgery had no influence on peritoneal permeability or adequacy of PD treatment. Conclusion: Laparoscopic technique is highly effective in children on PD especially related to catheter malfunction. It is an excellent option that enables restarting of PD shortly after the surgery.