Implante de cateter de diálise peritoneal: técnica de Seldinger e técnica cirúrgica, resultados no Hospital Universitário de Santa Maria
Autor(a) principal: | |
---|---|
Data de Publicação: | 2015 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Manancial - Repositório Digital da UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/5848 |
Resumo: | Peritoneal dialysis (PD) is a well-established modality of renal replacement therapy, which has as a principle for its proper function the guaranteed access to the peritoneal cavity. PD catheter implant technique should be safe, as well as provide minimal inconvenience to the patient, agility for the service, and few complications. At the University Hospital of Santa Maria (HUSM; Santa Maria, RS, Brazil), the catheters were inserted by laparotomy since the 1980s. It is been desired by the Nephrology department an alternative to facilitate the procedure, leading to greater agility and greater autonomy of the service. This study aimed to analyze the results obtained by professionals trained to implant peritoneal catheters with the Seldinger technique, recently implemented, and those obtained with the standard surgical technique. The samples were obtained from medical records of patients with endstage chronic kidney disease at the Nephrology department of HUSM with peritoneal dialysis indication (n=104). The demographic profile of the patients was evaluated, as well as the presence of infection and / or bleeding in the surgical wound, the first infusion and the 30-day functionality of the catheters, and the survival rate one and two years after implant. Data for each peritoneal catheter insertion mode were expressed as frequencies and then compared by chi-square, Fisher exact or Mann Whitey tests, with a 5% significance level. The profile of the two groups had similar characteristics in relation to gender, age, history of diabetes mellitus and arterial hypertension. The functionality of the implant at first infusion was also similar for both groups (83.9%for Seldinger vs. 79% for surgery). When evaluated the functionality in 30 days, the Seldinger technique demonstrated a higher success rate (76.7%) than the surgical technique (43.6%) (P-value=0,002). Regarding the presence of infection and / or bleeding in the outside wound, the percentage was similar for both groups (14.8% for Seldinger vs. 16.9% for surgical). The survival rate of the catheters at 1 and 2 years was also similar for both groups (37% and 14.8% for Seldinger, 23.7% and 20.6% for surgery, respectively). Given these results, it can be concluded that the implant of peritoneal catheters by Seldinger technique is a qualified alternative that allows greater agility to the service since it is an ambulatory procedure, can be performed by nephrologists and involves less patient management; having similar functionality to surgical implant according to the experience reported at HUSM. |
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2016-02-162016-02-162015-03-17PANSARD, Rafael Boeira. IMPLANT OF PERITONEAL DIALYSIS CATHETER: SELDINGER TECHNIQUE AND SURGICAL TECHNIQUE, RESULTS AT HUSM. 2015. 39 f. Dissertação (Mestrado em Medicina) - Universidade Federal de Santa Maria, Santa Maria, 2015.http://repositorio.ufsm.br/handle/1/5848Peritoneal dialysis (PD) is a well-established modality of renal replacement therapy, which has as a principle for its proper function the guaranteed access to the peritoneal cavity. PD catheter implant technique should be safe, as well as provide minimal inconvenience to the patient, agility for the service, and few complications. At the University Hospital of Santa Maria (HUSM; Santa Maria, RS, Brazil), the catheters were inserted by laparotomy since the 1980s. It is been desired by the Nephrology department an alternative to facilitate the procedure, leading to greater agility and greater autonomy of the service. This study aimed to analyze the results obtained by professionals trained to implant peritoneal catheters with the Seldinger technique, recently implemented, and those obtained with the standard surgical technique. The samples were obtained from medical records of patients with endstage chronic kidney disease at the Nephrology department of HUSM with peritoneal dialysis indication (n=104). The demographic profile of the patients was evaluated, as well as the presence of infection and / or bleeding in the surgical wound, the first infusion and the 30-day functionality of the catheters, and the survival rate one and two years after implant. Data for each peritoneal catheter insertion mode were expressed as frequencies and then compared by chi-square, Fisher exact or Mann Whitey tests, with a 5% significance level. The profile of the two groups had similar characteristics in relation to gender, age, history of diabetes mellitus and arterial hypertension. The functionality of the implant at first infusion was also similar for both groups (83.9%for Seldinger vs. 79% for surgery). When evaluated the functionality in 30 days, the Seldinger technique demonstrated a higher success rate (76.7%) than the surgical technique (43.6%) (P-value=0,002). Regarding the presence of infection and / or bleeding in the outside wound, the percentage was similar for both groups (14.8% for Seldinger vs. 16.9% for surgical). The survival rate of the catheters at 1 and 2 years was also similar for both groups (37% and 14.8% for Seldinger, 23.7% and 20.6% for surgery, respectively). Given these results, it can be concluded that the implant of peritoneal catheters by Seldinger technique is a qualified alternative that allows greater agility to the service since it is an ambulatory procedure, can be performed by nephrologists and involves less patient management; having similar functionality to surgical implant according to the experience reported at HUSM.A diálise peritoneal (DP) é uma modalidade bem estabelecida de terapia renal substitutiva, que tem como princípio para seu bom funcionamento a garantia de acesso à cavidade peritoneal. A técnica de implante do cateter de DP deve ser segura, além de proporcionar o mínimo de inconveniência para o paciente, agilidade para o serviço, e poucas complicações. No Hospital Universitário de Santa Maria (HUSM; Santa Maria, RS, Brasil) os cateteres foram implantados por laparotomia desde a década de 1980. É almejada pelo Serviço de Nefrologia uma alternativa que facilite o procedimento, levando a maior agilidade e autonomia do Serviço. O presente trabalho se propôs a analisar os resultados obtidos, por profissionais treinados para implante de cateter peritoneal com a técnica percutânea de Seldinger, recentemente implantada, e os resultados obtidos com a técnica padrão, a cirúrgica. As amostras foram obtidas de dados dos prontuários de pacientes entre os pacientes com insuficiência renal crônica terminal do Serviço de Nefrologia do HUSM com indicação de diálise peritoneal (n=104). Foi avaliado o perfil demográfico dos pacientes, assim como a presença de infecção e/ou sangramento na ferida operatória, a funcionalidade do cateter na primeira infusão e após30dias, além da taxa de sobrevivência em um e dois anos após o implante. Os dados obtidos em cada modalidade de implante de cateter peritoneal foram expressos em frequências e posteriormente comparados pelos testes Qui-Quadrado, Exato de Fischer ou Mann Whitey, com um nível de significância de 5%. O perfil dos dois grupos apresentou características semelhantes em relação ao gênero, idade, ocorrência de diabetes mellitus e hipertensão arterial. A funcionalidade do implante, na primeira infusão, também foi semelhante para os dois grupos (83,9% para Seldinger, 79% para cirúrgico). Quando avaliada a funcionalidade em 30 dias, a técnica de Seldinger mostrou um percentual de sucesso (76,7%) maior que a técnica cirúrgica (43,6%) (P-valor=0,002). Com relação à presença de infecção e/ou sangramento no orifício de saída, o percentual foi semelhante para os dois grupos (14,8% para Seldinger, 16,9% para cirúrgico). A taxa de sobrevivência dos cateteres em 1 e 2 anos também foi semelhante para os dois grupos (37% e 14,8% para Seldinger, 23,7% e 20,6% para cirúrgico, respectivamente). Diante dos resultados, pode-se concluir que o implante de cateter peritoneal pela técnica percutânea de Seldinger é uma alternativa qualificada que permite maior agilidade ao serviço já que o procedimento é ambulatorial, pode ser realizado por nefrologistas e implica em menor manejo do paciente; apresentando funcionalidade semelhante ao implante cirúrgico conforme a experiência relatada no HUSM.application/pdfporUniversidade Federal de Santa MariaPrograma de Pós-Graduação em Ciências da SaúdeUFSMBRMedicinaDiálise peritonealImplante percutâneoTécnica de SeldingerPeritoneal dialysisPercutaneous implantSeldinger techniqueCNPQ::CIENCIAS DA SAUDEImplante de cateter de diálise peritoneal: técnica de Seldinger e técnica cirúrgica, resultados no Hospital Universitário de Santa MariaImplant of peritoneal dialysis catheter: Seldinger technique and surgical technique, results at HUSMinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisCóser, Virgínia Mariahttp://lattes.cnpq.br/4601008307298787Weinmann, Angela Regina Macielhttp://lattes.cnpq.br/9151119377173425Velho, Maria Teresa Aquino de Camposhttp://lattes.cnpq.br/3242426873145535http://lattes.cnpq.br/5710378162239237Pansard, Rafael Boeira400000000001400300300500300e3c3ddb3-78b7-4b46-8a31-5614a42f1faa46c70837-36c5-4b27-beac-eee6cbb5636706679244-e12d-4d8d-b33e-0c7ee8fc645f86678ea7-e1b2-44aa-afbd-705ed2fb9bc4info:eu-repo/semantics/openAccessreponame:Manancial - Repositório Digital da UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMORIGINALPANSARD, RAFAEL BOEIRA.pdfapplication/pdf208208http://repositorio.ufsm.br/bitstream/1/5848/1/PANSARD%2c%20RAFAEL%20BOEIRA.pdf3587bd5dbb6f0747fce8e93e938c793dMD51TEXTPANSARD, RAFAEL BOEIRA.pdf.txtPANSARD, RAFAEL BOEIRA.pdf.txtExtracted texttext/plain66290http://repositorio.ufsm.br/bitstream/1/5848/2/PANSARD%2c%20RAFAEL%20BOEIRA.pdf.txta8149d7a673d764fd103325b980eeeffMD52THUMBNAILPANSARD, RAFAEL BOEIRA.pdf.jpgPANSARD, RAFAEL BOEIRA.pdf.jpgIM Thumbnailimage/jpeg4945http://repositorio.ufsm.br/bitstream/1/5848/3/PANSARD%2c%20RAFAEL%20BOEIRA.pdf.jpga123e6c68d4de03c2f0b935e05ba0869MD531/58482021-10-21 15:20:23.093oai:repositorio.ufsm.br:1/5848Repositório Institucionalhttp://repositorio.ufsm.br/PUBhttp://repositorio.ufsm.br/oai/requestopendoar:39132021-10-21T18:20:23Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.por.fl_str_mv |
Implante de cateter de diálise peritoneal: técnica de Seldinger e técnica cirúrgica, resultados no Hospital Universitário de Santa Maria |
dc.title.alternative.eng.fl_str_mv |
Implant of peritoneal dialysis catheter: Seldinger technique and surgical technique, results at HUSM |
title |
Implante de cateter de diálise peritoneal: técnica de Seldinger e técnica cirúrgica, resultados no Hospital Universitário de Santa Maria |
spellingShingle |
Implante de cateter de diálise peritoneal: técnica de Seldinger e técnica cirúrgica, resultados no Hospital Universitário de Santa Maria Pansard, Rafael Boeira Diálise peritoneal Implante percutâneo Técnica de Seldinger Peritoneal dialysis Percutaneous implant Seldinger technique CNPQ::CIENCIAS DA SAUDE |
title_short |
Implante de cateter de diálise peritoneal: técnica de Seldinger e técnica cirúrgica, resultados no Hospital Universitário de Santa Maria |
title_full |
Implante de cateter de diálise peritoneal: técnica de Seldinger e técnica cirúrgica, resultados no Hospital Universitário de Santa Maria |
title_fullStr |
Implante de cateter de diálise peritoneal: técnica de Seldinger e técnica cirúrgica, resultados no Hospital Universitário de Santa Maria |
title_full_unstemmed |
Implante de cateter de diálise peritoneal: técnica de Seldinger e técnica cirúrgica, resultados no Hospital Universitário de Santa Maria |
title_sort |
Implante de cateter de diálise peritoneal: técnica de Seldinger e técnica cirúrgica, resultados no Hospital Universitário de Santa Maria |
author |
Pansard, Rafael Boeira |
author_facet |
Pansard, Rafael Boeira |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Cóser, Virgínia Maria |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/4601008307298787 |
dc.contributor.referee1.fl_str_mv |
Weinmann, Angela Regina Maciel |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/9151119377173425 |
dc.contributor.referee2.fl_str_mv |
Velho, Maria Teresa Aquino de Campos |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/3242426873145535 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/5710378162239237 |
dc.contributor.author.fl_str_mv |
Pansard, Rafael Boeira |
contributor_str_mv |
Cóser, Virgínia Maria Weinmann, Angela Regina Maciel Velho, Maria Teresa Aquino de Campos |
dc.subject.por.fl_str_mv |
Diálise peritoneal Implante percutâneo Técnica de Seldinger |
topic |
Diálise peritoneal Implante percutâneo Técnica de Seldinger Peritoneal dialysis Percutaneous implant Seldinger technique CNPQ::CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
Peritoneal dialysis Percutaneous implant Seldinger technique |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE |
description |
Peritoneal dialysis (PD) is a well-established modality of renal replacement therapy, which has as a principle for its proper function the guaranteed access to the peritoneal cavity. PD catheter implant technique should be safe, as well as provide minimal inconvenience to the patient, agility for the service, and few complications. At the University Hospital of Santa Maria (HUSM; Santa Maria, RS, Brazil), the catheters were inserted by laparotomy since the 1980s. It is been desired by the Nephrology department an alternative to facilitate the procedure, leading to greater agility and greater autonomy of the service. This study aimed to analyze the results obtained by professionals trained to implant peritoneal catheters with the Seldinger technique, recently implemented, and those obtained with the standard surgical technique. The samples were obtained from medical records of patients with endstage chronic kidney disease at the Nephrology department of HUSM with peritoneal dialysis indication (n=104). The demographic profile of the patients was evaluated, as well as the presence of infection and / or bleeding in the surgical wound, the first infusion and the 30-day functionality of the catheters, and the survival rate one and two years after implant. Data for each peritoneal catheter insertion mode were expressed as frequencies and then compared by chi-square, Fisher exact or Mann Whitey tests, with a 5% significance level. The profile of the two groups had similar characteristics in relation to gender, age, history of diabetes mellitus and arterial hypertension. The functionality of the implant at first infusion was also similar for both groups (83.9%for Seldinger vs. 79% for surgery). When evaluated the functionality in 30 days, the Seldinger technique demonstrated a higher success rate (76.7%) than the surgical technique (43.6%) (P-value=0,002). Regarding the presence of infection and / or bleeding in the outside wound, the percentage was similar for both groups (14.8% for Seldinger vs. 16.9% for surgical). The survival rate of the catheters at 1 and 2 years was also similar for both groups (37% and 14.8% for Seldinger, 23.7% and 20.6% for surgery, respectively). Given these results, it can be concluded that the implant of peritoneal catheters by Seldinger technique is a qualified alternative that allows greater agility to the service since it is an ambulatory procedure, can be performed by nephrologists and involves less patient management; having similar functionality to surgical implant according to the experience reported at HUSM. |
publishDate |
2015 |
dc.date.issued.fl_str_mv |
2015-03-17 |
dc.date.accessioned.fl_str_mv |
2016-02-16 |
dc.date.available.fl_str_mv |
2016-02-16 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
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masterThesis |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
PANSARD, Rafael Boeira. IMPLANT OF PERITONEAL DIALYSIS CATHETER: SELDINGER TECHNIQUE AND SURGICAL TECHNIQUE, RESULTS AT HUSM. 2015. 39 f. Dissertação (Mestrado em Medicina) - Universidade Federal de Santa Maria, Santa Maria, 2015. |
dc.identifier.uri.fl_str_mv |
http://repositorio.ufsm.br/handle/1/5848 |
identifier_str_mv |
PANSARD, Rafael Boeira. IMPLANT OF PERITONEAL DIALYSIS CATHETER: SELDINGER TECHNIQUE AND SURGICAL TECHNIQUE, RESULTS AT HUSM. 2015. 39 f. Dissertação (Mestrado em Medicina) - Universidade Federal de Santa Maria, Santa Maria, 2015. |
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openAccess |
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Universidade Federal de Santa Maria |
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UFSM |
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BR |
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Medicina |
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Universidade Federal de Santa Maria |
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