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복막투석 도관삽입시 기 Y - TEC 방벙 변형술의 호율성 및 안전성 |
이태원 , 정인경 , 홍성표 , 임천규 , 김명재 , 안재형 |
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Abstract |
The Y-tec system is an equipment for the peritoneoscopic placement of peritoneal dialysis catheter. The advantage of this method is the direct visualization of peritoneal cavity by using a small diameter minitrocar and dilatable guide. But this method has some limitations because of the expensive equipment and the difficulty in being expert at peritoneoscopy. We placed the CAPD catheter by using a mini- trocar without peritoneoscopy(so called Modified Y- tec system) in 44 patients who had no history of major aMominal surgery@(MY-group), the classic Y- tec system in 8 patients(Y-group), and surgical method in 13 patients with history of major aMo- minal surgery(S-group) and compared the effecacy and safety of three methods. MY-group Y-group S-group (44) (8) (13) Required time(min) Length of incision (cm) Degree of pain Blood stain Frequency Duration(day) Bowel perforation Inflow failure 18±2 1.2±0.2 I Il 3(6.8%) 2-3 0 0 20±2 1.2±0.2 I II 25±3 7.8±1.9 III- IV Outflow failure (<2wk) Leakage(<2wk) 2(3.8%) 0 Peritonitis (case/pt.year) ESI(case/pt.year) Leakage(>2wk) Hernia 0.67 0.27 3(6.8%) 0 1(12.5%) 7(53.8%) 2-3 5-6 0 0 0 0 0 0 2(15.4%) 1(7.7%) 0.72 0.28 0 0 0.92 0.37 1(7.7%) 1(7.7%) ESI: exit site infection. In conclusion, the short and long term results of blind minitrocar placements were comparable to, or better than the surgical and other percutaneous methods of catheter implantation when they were used in the patients without history of major abdominal surgery. |
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