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Pre-sternal and Extended Catheters

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Surgical Aspects of Peritoneal Dialysis

Abstract

Peritoneal dialysis is an important dialysis modality used in the management of the patients with end stage renal disease. Success of the peritoneal dialysis depends on obtaining and maintaining a good access to the peritoneal cavity. Obtaining a peritoneal access with longer survival, reduced catheter related infections and complications are crucial for effective peritoneal dialysis. The introduction of Missouri Swan neck pre-sternal catheters gave whole new dimension to the world of peritoneal dialysis. These catheters are not only associated with reduced catheter associated complications but also reduced exit site and tunnel infections, peri-catheter leaks, catheter tip migration, cuff extrusion and peritonitis. Further, patients with ostomies and obesity also do better with the pre-sternal catheters. Overall, patient’s acceptance of pre-sternal exit site is better. These catheters have a coiled intra-abdominal segment; a titanium adaptor joins the abdominal segment to the upper segment. The upper segment has two cuffs, one on either side of pre-sternal swan-neck segment. The present chapter describes the advantages of pre-sternal swan neck catheters over conventional abdominal peritoneal dialysis catheters with various methods of implantation of pre-sternal catheters.

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Authors and Affiliations

  1. Division of Nephrology, Department of Medicine, University of Missouri-Columbia, Columbia, MO, USA

    Fahad Aziz MD

  2. Department of Surgery, University of Missouri-Columbia, Columbia, MO, USA

    W. Kirt Nichols MD, MHA

Authors
  1. Fahad Aziz MD
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  2. W. Kirt Nichols MD, MHA
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Correspondence to W. Kirt Nichols MD, MHA .

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Editors and Affiliations

  1. Division of Gastrointestinal and General Surgery, NorthShore University HealthSystem, Evanston, Illinois, USA

    Stephen Haggerty

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Aziz, F., Kirt Nichols, W. (2017). Pre-sternal and Extended Catheters. In: Haggerty, S. (eds) Surgical Aspects of Peritoneal Dialysis. Springer, Cham. https://doi.org/10.1007/978-3-319-52821-2_9

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  • DOI: https://doi.org/10.1007/978-3-319-52821-2_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-52820-5

  • Online ISBN: 978-3-319-52821-2

  • eBook Packages: MedicineMedicine (R0)

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