Abstract: 【Abstract】Objective To observe the improved peritoneal dialysis (PD) catheter implantation technique on PD catheter dysfunction. Method Patients surviving at least 4 weeks after operative catheter insertion between November 2011 and November 2013 in our center were included in this study. The operation was performed by our physicians using swan-neck or straight double-cuffed Tenckhoff catheter. The implantation technique was modified as follows: (1) catheters were placed at 7-9.0cm upper the symphysis pubis and 1-2.0cm to the left or right side; (2) catheters were flushed with heparin to make it heparinization before placement; and (3) hollow sensation without resistance existed during the catheter placement utilizing a guide-wire. Results Of the 133 PD patients enrolled in the study, 82 were females, and 51 were males. The mean age was 49.2±14.6 years and the median follow-up vintage was 11.0 (6.0~16.5) months. The primary diseases included chronic glomerulonephritis (n=87), diabetic nephropathy (n=21), and others (n=25). Swan-neck (n=131) or straight (n=2) double-cuffed Tenckhoff catheters were used. During the follow-up period, catheter migration was found in one case, and was successfully relieved by conservative treatment including flushing, abdominal massage, laxatives, and ambulation; poor drainage of the tubes were present in 5 cases using swan neck Tenckhoff catheters, and two of them were blocked by blood clots that were cleared by use of heparin saline and urokinase; tube wrapped by omentum was found in one case after the operation and CAPD for 6 months, and regained patency after operation; one case had poor drainage 35 days after the insertion, the location of the tube was adequate by X-ray examination, the problem remained after conservative treatment for two weeks, and the patient was then changed to hemodialysis. The one year catheter survival was 98%. Conclusion The incidence of catheter dysfunctional problems became lower in our PD center after the application of the modified PD catheter implantation technique.

Key words: peritoneal dialysis, catherization, dysfunction, heparinization