- Design
- Systematic review and meta-analysis
- Population
- 13 studies, 1,275 patients undergoing open PD catheter placement
- Primary outcome
- Catheter displacement and complications
- Effect
- Displacement OR 0.08 (95% CI 0.04–0.16); operating time +4.2 minutes
This meta-analysis pooled 13 studies comparing fixation with no fixation of the peritoneal dialysis catheter during open surgical placement, involving 648 and 627 patients.
Fixation sharply reduced catheter displacement (OR 0.08, 95% CI 0.04–0.16). There was no significant difference in catheter malfunction without displacement, omental wrapping, infection, bleeding, infusion pain or hernia. Fixation added about four minutes to the operation.
Catheter migration is one of the commonest reasons for early peritoneal dialysis failure and repeat surgery. For units placing catheters by open surgery, which is common in India, fixation is a simple step. The included studies were drawn largely from Chinese databases and their quality is not reported in the abstract, so the size of the effect may be overstated.
- Consider fixing the catheter tip or segment during open PD catheter insertion.
- Expect fewer displacements without a rise in infection, bleeding or hernia.
- Allow a few extra minutes of operating time.
- Track catheter migration rates in your unit to judge the effect locally.
Why it matters
Catheter displacement is a leading, preventable cause of early PD technique failure.
Don't overread it
Study quality is not reported in the abstract, and most data come from single-country studies.
The statistics, in plain English
An odds ratio of 0.08 means the odds of displacement were about 92% lower with fixation. For the other complications, the intervals are wide and cross 1, so no difference was shown, but rare harms cannot be excluded.
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