Laparoscopic and Percutaneous Peritoneal dialysis Catheter Outcomes Are Comparable: Study
A new meta-analysis suggests that peritoneal dialysis catheter placement using either laparoscopic or percutaneous techniques produces largely similar clinical outcomes, indicating that both approaches are viable options for patients with end-stage renal disease. This study was published in BMC Nephrology by Xiaoxi W. and colleagues. Although peritoneal dialysis remains a safe and efficient renal replacement therapy for patients with ESRD, the optimal modality of catheter insertion has long been a point of discussion due to the different complication profiles and the various procedural difficulties.
Currently, open surgery remains the most widely used technique in clinical practice; however, minimally invasive approaches-including laparoscopic and percutaneous insertion-have gained increasing adoption. This meta-analysis was registered prospectively on the PROSPERO database (CRD42024509930). An extensive literature search was conducted in EMBASE, PubMed, Web of Science, and CNKI, based on broad international coverage. For statistical analysis, Review Manager, version 5.4.1, was used. All studies comparing laparoscopic and percutaneous PD catheter placements were included, with the focus of analysis resting on the outcomes regarding complications and the perioperative period.
Key Findings
Laparoscopic procedures were associated with a longer operative time compared with percutaneous catheter placement.
No statistically significant difference was observed between the two techniques in terms of length of hospital stay.
There were no significant differences between the laparoscopic and percutaneous insertion in rates of:
Exit-site infections
Failure or malfunction of the catheter
Hernia
Dialysate leakage
Both techniques demonstrated comparable safety and effectiveness across evaluated outcomes.
This meta-analysis showed that the clinical outcomes for both the laparoscopic and percutaneous peritoneal dialysis catheter insertion techniques were equivalent, though differing in some respects regarding operative time and risk of bleeding. While laparoscopic insertion may reduce postoperative bleeding, neither approach had the edge in complications or duration of hospital stay. Larger multicenter randomized studies are yet needed to establish these findings and further delineate clinical guidelines.
Reference:
Wang, X., Jin, W., Li, X. et al. Percutaneous versus laparoscopic catheter placement for peritoneal dialysis: a meta-analysis. BMC Nephrol 26, 687 (2025). https://doi.org/10.1186/s12882-025-04597-z
