Tranaeus A, Danielsson A, Hylander B, Blohme L, Eriksson C,
Malmberg E
Randomized study of peritoneal dialysis catheter implantation
using Moncrief and conventional techniques
International Society of Blood Purification
Blood Purif
(Sep) 13:(supp.1)29 1995
If patients were able to wait 6 weeks for initiation of dialysis and
consented, they were
randomized to receive a Moncrief approach for catheter implantation vs
conventional approach,
as described in the Park abstract above. Coiled, Swan-neck, extended distal
cuff Moncrief
catheters were implanted laterally with the inner cuff in the rectus muscle
in all 57 patients. The
patients randomized to conventional technique had a similar approach except
that the catheter
was externalized at the initial operation while the Moncrief approach
patients had a second
externalization operation. The same surgeons (one at each of two centers)
did all the surgery.
The follow-up period was about 2 years. The mean time from implantation to
initiation of PD
was 2.5 months. In the Moncrief approach group the infection free
peritonitis interval was 97
months (only 3 episodes) and in the conventional approach group it was 34
months (6 episodes).
The incidence of exit site infections did not differ.
This study suggests that the prolonged period between implantation and first
PD may be
contributory to a low infection rate.
(T.A. Golper)
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International Society of Blood Purification
Basic peritoneal dialysis :
PD catheters