Korean Journal of Nephrology 1991;10(1):96-104.

계속적외래복막투석에서의 Swan Neck 도관의 사용

권태환 , 임종우 , 김동희 , 김성호 , 조동규 , 김영욱 , 정영순

Abstract

Continuous ambulatory peritoneal dialysis has been utilized frequently as an alternative method of treat- ment for patients with end-stage renal disease. The key to successful chronic peritoneal dialysis is a permanent and safe access to the peritoneal cavity. Despite of improvement in catheter survivaI over the last several years with reduction in the incidence of peritonitis, catheter-related complications still occur, causing sig- nificant morbidity and often forcing removal of the catheter. Twardowski et al recommended swan neck catheter, a new catheter permanently bent between cuffs to eliminate silastic resilience force or the "shape memory which tends to extrude the external cuff. This study analyzed the experience with 61 patients (72 catheters: 22 swan neck and 50 straight Tenckhoff) retrospectively, and compared two catheters with re- spect to catheter survival and frequency of catheter- related complications. The results are as follows: By life table analysis, cumulative survival rates of swan neck catheter were 81%, 75% and 75% at 3, 6 and 9month respectively, and those of straight Tenckhoff catheter 92%, 88%, 88%at 3, 6, 9month respectively. There was no significant difference between swan neck and straight Tenckhoff catheters with respect to cath- eter survival. The 17(5 swan neck and 12 straight Tenckhoff) cath- eter failures, which required catheter replacement, were due to peritonitis (10:swan neck 3, straight Tenckhoff 7), dislodgment (5:swan neck 2, straight Tenckhoff 3), obstruction (1:straight Tenckhoff) and catheter tearing (1:straight Tenckhoff). Sixty five percents of catheter failure occurred within the first 4 months and these were mainly due to peritoni- tis. There was no significant difference between swan neck and straight Tenckhoff catheters with respect to catheter related complications eritonitis (swan neck:0. 18/patient-months, straight Tenckhoff:0. 22/patient- menths), dislodgment (0.07 vs 0.03), leakage (0.03 vs 0. 09), tunnel infection (0.008 vs 0.003) and exit-site infec- tion (0.053 vs 0.009). In conclusion, these results indicate that there is no difference between swan neck and straight Tenckhoff catheters with respect to catheter survival and catheter-related complications.