[The surgical problems of continuous ambulatory peritoneal dialysis: 3 years of experience].

Purpose: This study presents the surgical problems of CAPD catheter insertion and mechanical complications in 37 cases (39 peritoneal dialysis catheters inserted for CAPD), being our experience along a time period of 3 years.

Materials And Methods: The catheters were of Tenckhoff-type, with double Dacron cuff (Fresenius Medicale Care). We used an open-type surgical procedure with spinal anaesthesia.

Results: In all the 8 cases with previous abdominal interventions the catheters were functional. We found an early catheter obstruction only in two cases, by means of a "greater omentum fimbriae". In the third case a partial omentectomy was performed. In 1 patient with parietal granuloma and frequent peritonitis a new peritoneal catheter was inserted (with a new tegumentary outlet). Hernia was found in 1 patient and was successfully cured by means of surgical intervention. This patient continued the CAPD treatment. In 2 cases we interrupted the CAPD treatment (one renal transplant; one converted to hemodialysis). 25 patients had no catheter-related complications.

Conclusion: We wish to state that catheter occlusion and hernia must not lead to an abandon of CAPD treatment.