Single- and double-purse-string suture catheter insertion methods for dialysis have similar complication and survival rates: Study

Peritoneal dialysis depends on safe and efficient catheter placement, and reducing complications is important for the outcome of a patient. Although there has been variability in surgical technique, the evidence to clearly support an advantage of one technique over another has been sparse. This study closes that gap by providing strong comparative data at three years' follow-up.

This retrospective study analyzed data on 142 patients who were catheterized for peritoneal dialysis using the single-purse-string suture technique (Group S) or the double-purse-string suture technique (Group D). Patients in both groups were matched for their baseline clinical characteristics to allow for comparison. Both infection-related and non-infection-related complications following insertion of the catheter were assessed, along with technical and patient survival at three years. Kaplan–Meier survival analysis was used to estimate technical and patient survival, and the log-rank test was used to compare outcomes between the two groups.

Key Findings

Complication Rates:

Infection-related complications in the first month:

• Group S: 2.8%

• Group D: 5.6% (p=0.377)

Non-infection-related complications:

• Group S: 2.1%

• Group D: 2.8% (p=1.000)

Technical Survival:

Kaplan–Meier estimates of technical survival at 1, 2, and 3 years:

• Group S: 96.3%, 90.4%, and 85.9%

• Group D: 89.9%, 86.7%, and 84.8% (log-rank test, p=0.439)

Patient Survival:

• Comparable between both groups over the three-year follow-up period (log-rank test, p=0.647).

This study concludes that the single-purse-string suture method provides comparable outcomes in terms of post-insertion complications, technical survival, and patient survival with the double-purse-string method. The results support the single-purse-string method to be used as a standard procedure for peritoneal dialysis catheter placement since it is simpler and equally effective as the more complex double-purse-string technique.

Reference:

Li, X., Chen, X., Gao, H., Zhou, Q., Liu, W., Li, P., Li, Y., Wang, S., Chen, J., & Li, G. (2024). Comparative analysis of complications and technique survival in peritoneal dialysis catheter insertion: single purse-string suture vs. double purses-string suture. Renal Failure, 46(2). https://doi.org/10.1080/0886022x.2024.2435209