• Muhammad Ibrar Hussain
  • Saleh Mohammed Al-Salamah
  • Rizwan Aziz
  • Hamad Hadi Al-Qahatani
  • Nasir Yazeed Al-Ohay
  • Fahad Al-Jabar


Background: Continuous ambulatory peritoneal dialysis (CAPD) has become a popular and established form of renal replacement therapy in patients with end-stage renal disease (ESRD). The objective of this study was to analyse the outcome of open Tenckhoff catheter insertions in patients with ESRD in term of catheter related complications. Methods: From December 2006 to November 2011, 337 Tenckhoff catheters were placed in 305 patients with ESRD for CAPD, by general surgeons in King Saud Medical City, Riyadh, Saudi Arabia. Medical record of all these patients was reviewed retrospectively regarding the demography, causes of ESRD, catheter related complications, and their management. Results: Mean age of the patients was 51.2±14.5 (range, 16–87years). Majority of the patients were female 164 (53.7%). Forty three patients (14.1%) had previous abdominal surgery. Diabetic nephropathy was the commonest (51.4%) primary cause of ESRD. Ninety three insertions (27.5%) were associated with complications. Post insertion peritonitis was the commonest complication (9.2%) in our series, followed by mechanical dysfunction (8.6%). Fifty two catheters (15.4%) were removed because of different complications. Follow up ranged between 4–47 months with a mean of 21.4±11.2 months. Conclusions: Open surgical approach is simple, safe, and effective method of Tenckhoff catheter insertion with an acceptable complication rate, provided patients are adequately optimized and prepared for surgery.Keywords: Continuous ambulatory peritoneal dialysis (CAPD), End stage renal disease (ESRD), Tenckhoff catheter, complications, peritonitis, mechanical dysfunction


Tiong HY, Poh J, Sunderaraj K, Wu YJ, Consigliere DT. Surgical complications of Tenckhoff catheters used in continuous ambulatory peritoneal dialysis. Singapore Med J 2006;47:707–11.

Lo WK. Peritoneal dialysis utilization and outcome: what are we facing? Perit Dial Int 2007;27(Suppl 2):S42–7.

Yang PJ, Lee CY, Yeh CC, Nien HC, Tsai TJ, Tsai MK. Mini-Laparotomy implantation of peritoneal dialysis catheters: outcome and rescue. Perit Dial Int 2010;30:513–8.

Liu WJ, Hooi LS. Complications after Tenckhoff catheter insertion: A single- center experience using multiple operators over four years. Perit Dial Int 2010;30:509–12.

Flanigan M, Gokal R. Peritoneal catheters and exit–site practices toward optimum peritoneal access: a review of current developments. Perit Dial Int 2005;25:132–9.

Hwang TL, Chen MF, Wu CH, Leu ML, Huang CC. Comparison of four techniques of catheter insertion in patients undergoing continuous ambulatory peritoneal dialysis. Eur J Surg 1995;161:401–4.

Alwakeel JS, Alsuwaida A, Askar A, Memon N, Usama S, Alghonaim M, et al. Outcome and complications in peritoneal dialysis patients: a five –year single center experience. Saudi J Kidney Dis Transpl 2011:22(2):245–51.

Sirivings D, Praderm L, Chan- On C. Experience on bedside Tenckhoff catheter implantation. J Med Assoc Thai 2011;94(Suppl 4):S58–63.

Regoczi T, Josvay J, Ballint A, Csaba J, Rakossy W, Foder E et al. Experience with Tenckhoff peritoneal dialysis catheter. Orv Hetil 2009;150:2110–4.

Valdivia-Gomez GG, Jaramillo-de la Torre E. Para median or midline approach in the insertion of a Tenckhoff catheter in patients with ambulatory continuous peritoneal dialysis. Comparative study. Cir Cir 2004;72(3):193–201.

Ortiz AM, Fernandez MA, Troncoso PA, Guzmán S, Del Campo F, Morales RA. Outcome of peritoneal dialysis: Tenckhoff catheter survival in a prospective study. Adv Perit Dial 2004;20:145–9.

Luvira V, Satirapoj B, Supasyndh O, Chaiprasert A, Ruangkanchanasetr P, Nata N, et al. A Single- centre experience: peritoneal dialysis- related infections in patients on long -term dialysis. J Med Assoc Thai 2011;94(Suppl 4):30–6.

Soontrapornchai P, Simapatanapong T. Comparison of open and laparoscopic secure placement of peritoneal dialysis catheters. Surg Endosc 2005;19:137–9.

Ogunc G, Tuncer M, Ogunc D, Yardimsever M, Ersoy F. Laparoscopic omental fixation technique versus open surgical placement of peritoneal dialysis catheters. Surg Endosc 2003;17:1749–55.

Ogunc G. Videolaparoscopy with omentopexy; a new technique to allow placement of a catheter for continuous ambulatory peritoneal dialysis. Surg Today 2001;31:942–4.

Crabtree JH, Fishman A. Selective performance of prophylactic omentopexy during laparoscopic implantation of peritoneal dialysis catheters. Surg Laparosc Endosc Percutan Tech 2003;13(3):180–4.

Maio R, Figueiredo N, Costa P. Laparoscopic placement of Tenckhoff catheters for peritoneal dialysis: A safe, effective and reproducible procedure. Perit Dial Int 2008;28:170–3.

Keshvari A, Najafi I, Jafari-Javid M, Yunesian M, Chaman R, Taromlou MN. Laparoscopic peritoneal dialysis catheter implantation using a Kenckhoff trocar under local anesthesia with nitrous oxide gas insufflations. Am J Sur 2009;197:8–13.

Lu CT. Watson DI, Elias TJ, Faull RJ, Clarkson AR, Bannister KM. Laparoscopic placement of peritoneal dialysis catheters: 7 years experience. ANZ J Surg 2003;73:109–11.

Jwo Sc, Chen KS, Lee CC, Chen HY. Prospective randomized study for comparison of open surgery with laparoscopic –assisted placement of Tenckhoff peritoneal dialysis catheter-a single center experience and literature review. J Surg Res 2010;159:489–96.

Wright MJ, Bel’eed K, Johnson BF, Eadington DW, Sellars L, Farr MJ. Randomized prospective comparison of laparoscopic and open peritoneal dialysis catheter insertion. Perit Dia Int 1999;19:372–5