Comparison of the Seldinger Technique and Surgical Technique in Tenckhoff Catheter Insertion in CAPD Patients: A Single Center Experience
Kamol Khositrangsikun MD*, Wipapat Chujohn RN*, Chavasak Kanokkantapong MD**, Talerngsak Kanjanabuch MD***
Affiliation : * Department of Medicine, Maharaj Nakhon Si Thammarat Hospital, Nakhon Si Thammarat, Thailand ** Department of Medicine, Maharaj Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand *** Division of Nephrology, Department of Medicine and Kidney & Metabolic Research Center, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Objective : To compare clinical outcomes of catheter placement between surgical technique and Seldinger technique, including
catheter survival and early post-operative complications.
Material and Method: This retrospective study was conducted in Maharaj Nakhon Si Thammarat Hospital, a tertiary-center
hospital in southern part of Thailand. Three-year data, during October 2007-2010, were retrieved from medical records and
hospital database. Early post-operative complications, including major bleeding, peritoneal leakage, and peritonitis rate, and
long-term outcome were assessed.
Results : One hundred forty-nine and 56 out of 205 patients were inserted Tenckhoff catheter by surgical technique and
Seldinger technique, accordingly. The average age was 49.8 years old. Sixty percent of them were male. Neither of early post-
operative complication and long-term outcome was found to have significant difference. However, patients with surgical
technique received more topical antibiotic [15 (10.0%) vs. 0 (0%), p = 0.014] and trended to have more episode of early post-
operative peritonitis [15 (10.1%) vs. 3 (5.4%) p = 0.288].
Conclusion : Although Seldinger technique is more feasible for practical nephrologists and less time consumption; the
success, early post-operative complications, and long term outcome are comparable with surgical technique. The surgeons
or nephrologists who perform catheter placement should be aware of catheter-related infection, especially in the first few
weeks.
Keywords : Dialysis catheter insertion, Tenckhoff catheter insertion, Catheter Implantation, Seldinger method
