The Survival and Complication Rates of Laparoscopic Versus Open Catheter Placement in Peritoneal Dialysis Patients: A Meta-Analysis.

The objective of this meta-analysis was to compare the outcomes of laparoscopic insertion method with a conventional open surgery. A systematical search was conducted in PubMed, Embase, and the Cochrane Library up to June 2014. Relative risks (RRs) and their 95% confidence intervals (CIs) were used as estimates. Four randomized-controlled trials and 10 cohort studies involving 2323 patients were identified. The pooled results showed that laparoscopic insertion technique significantly prolonged the 1-year survival (RR=1.23; 95% CI, 1.12-1.35) and 2-year survival (RR=1.36; 95% CI, 1.16-1.60). Meanwhile, laparoscopic insertion significantly decreased the probability of surgical intervention or catheter revision (RR=0.32; 95% CI, 0.15-0.69) and risk of migration (RR=0.31; 95% CI, 0.18-0.53) and obstruction (RR=0.43; 95% CI, 0.28-0.66). Thus, laparoscopic catheter placement may be superior to open surgery in peritoneal dialysis catheter placement.