Peritoneal dialysis catheter embedment: surgical considerations, expectations, and complications.

Crabtree, John H; Burchette, Raoul J

BACKGROUND Peritoneal dialysis catheter embedment consists of implanting the catheter far in advance of anticipated need, with the external tubing buried under the skin. The catheter is externalized when initiation of dialysis is required. Details of the surgical procedure and management of associated complications are generally lacking. METHODS A total of 84 catheters including conventional and extended catheters were embedded and externalized during the study period. Factors influencing duration of embedment, functionality upon externalization, and long-term outcomes were analyzed. RESULTS Mean duration of embedment was 13.9 months (median 9.4; range .5 to 68.5). Immediate function was exhibited in 85.7% of catheters. Employing laparoscopic revision, 98.8% of embedded catheters were successfully used for peritoneal dialysis. Extended catheters and duration of embedment were important determinants of catheter functionality. CONCLUSIONS Catheters can be embedded for prolonged periods and still result in functional dialysis access when needed. Complications are few and easily managed.