Comparison of peritoneal dialysis catheter placement techniques on dialysate leakage characteristics in a beagle model.

BACKGROUND

Dialysate leakage is a common mechanical complication associated with peritoneal dialysis catheter placement. Experimental animal models may help to characterize the biomechanical responses of the abdominal wall to different catheter insertion techniques under controlled conditions.

METHODS

Fifteen healthy adult male beagles were randomly assigned to three groups (n = 5 per group) according to the catheter placement technique: open surgery with single purse-string suture, open surgery with double purse-string suture, and the Seldinger technique. After catheter placement, dialysate was continuously infused into the peritoneal cavity. Intra-abdominal pressure (IAP), infused dialysate volume at the onset of leakage, drained volume, and residual volume were recorded and compared among groups.

RESULTS

All catheter placements were technically successful, and dialysate leakage occurred at the incision site in all animals. The Seldinger technique group demonstrated significantly higher IAP and larger infused dialysate volumes at the time of leakage compared with both open surgery groups (P < 0.001). Within the open surgery groups, the double purse-string suture was associated with higher IAP and infused volumes at leakage than the single purse-string suture (P < 0.01). No significant differences in residual dialysate volume or catheter-related mechanical complications were observed among the three groups.

CONCLUSIONS

Different peritoneal dialysis catheter placement techniques resulted in distinct abdominal pressure responses and leakage characteristics. Urgent-start peritoneal dialysis can be performed immediately, safely, and effectively with both open surgery and the Seldinger technique. The Seldinger technique may be preferable to open surgical placement for preventing short-term leakage complications in beagles.