Abstract
In children undergoing CAPD or CCPD, the authors compared two techniques for peritoneal catheter insertion by analyzing the probabilities for overall catheter survival, catheter outflow failure and peritonitis. Between January 1980 and December 1982, catheters were installed with a slightly arcuate subcutaneous tunnel with a predominantly transverse orientation. After December 1982 catheters were implanted with a straight subcutaneous tunnel directed caudally toward the pelvis. We found that a catheter directed toward the pelvis was associated with improved overall survival. Adoption of this technique greatly reduced outflow obstruction, the leading cause of catheter failure before 1983. However, the orientation of the extraperitoneal catheter segment did not appear to influence the overall risk for peritonitis.
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