A NEW SELF-LOCATING PERITONEAL CATHETER

Objective: Peritoneal catheters often become dislocated, and this may lead to malfunction. Since it is not usually possible to bring them ba ck into their correct position, they must be replaced. With the aim of preventing this complication, we designed a new catheter. Design: The new catheter has the same form as the Tenckhoff catheter except for a small increase in external diameter of the last 2 cm, made possible b y the high specific weight of a small 12-g tungsten cylinder incorpora ted in the Silastic at the abdominal end. The new catheter may be inse rted by a percutaneous technique. Setting: University hospitals of Sie na and Perugia, Italy. Patients: In the last three years, 32 of these catheters have been implanted for a total experience of 468 patient-mo nths. Their position was checked on insertion and every two months the reafter by radiography; 26 Tenckhoff catheters (415 patient-months) we re studied at the same time. Insertion was performed surgically and by a percutaneous method. The frequency of cuff extrusion, exit-site inf ections, leakage, and peritoneal infection were noted, together with p eritoneal function, which was evaluated by KT/V and weekly creatinine clearance one month after catheter insertion; the tests were repeated when dislocation occurred and at the end of the trial. Results: No dis locations occurred with the self-locating catheters, whereas nine disl ocations occurred in control patients (p = 0.0003). There were no sign ificant differences with respect to controls for cuff extrusion, exit- site infections, leakage, peritoneal infection, and peritoneal functio n. Conclusions: The presence of a small weight at the catheter tip pre vents displacement completely, keeping the intraperitoneal part of the catheter in place.