Application of Continuous Quality Improvement in Laparoscopic Peritoneal Dialysis Catheter Input_West China Medical Journal

Authors：

 LIUYa ¹ , JIAQian-bin ² , QINMin ¹ , ZHOUXue-li ¹ , LIZi ¹ ,  TANGXiao-hong ¹

1. Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Hepatobiliary Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

TANGXiao-hong, Email: xhtng@126.com

Keywords：

Peritoneal dialysis; Continuous quality improvement; Catheter migration; Plugging; Leakage; Laparoscopic assisted surgery

DOI：

10.7507/1002-0179.20140556

Video：

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Objective To reduce the incidence of peritoneal dialysis (PD) catheter complications through a continuous quality improvement (CQI) process. Methods Twenty-nine patients with catheters inserted (from January 2011 to March 2011) before CQI, and another 41 patients with catheters inserted (between April 2011 and January 2012) after CQI were observed and analyzed. The possible causes of complications of catheter were summarized, and then on the basis of that, a PDCA four-step (plan-do-check-act) method was designed with a view to reducing the incidence of postoperative complications. Results PD catheter dysfunction decreased from 6.90% to 2.44%. The incidence of leakage decreased from 44.83% to 9.76%. Conclusion CQI is a useful method to reduce the incidence of postoperative complications of PD catheter in peritoneal dialysis.

Citation： LIUYa, JIAQian-bin, QINMin, ZHOUXue-li, LIZi, TANGXiao-hong. Application of Continuous Quality Improvement in Laparoscopic Peritoneal Dialysis Catheter Input. West China Medical Journal, 2014, 29(10): 1827-1831. doi: 10.7507/1002-0179.20140556 Copy

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11.	Jwo SC, Chen KS, Lee CC, et al. 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]. J Surg Res, 2010, 159(1):489-496.
12.	Crabtree JH, Fishman A. Videolaparoscopic implantation of long-term peritoneal dialysis catheters[J]. Surg Endosc, 1999, 13(2):186-190.
13.	Crabtree JH, Fishman A. Laparoscopic omentectomy for peritoneal dialysis catheter flow obstruction:a case report and review of the literature[J]. Surg Laparosc Endosc Percutan Tech, 1999, 9(3):228-233.
14.	Ogunc G. Minilaparoscopic extraperitoneal tunneling with omentopexy:a new technique for CAPD catheter placement[J]. Perit Dial Int, 2005, 25(6):551-555.
15.	Numanoglu A, Rasche L, Roth MA, et al. Laparoscopic insertion with tip suturing, omentectomy, and ovariopexy improves lifespan of peritoneal dialysis catheters in children[J]. J Laparoendosc Adv Surg Tech A, 2008, 18(2):302-305.
16.	郝世軍,王衛軍, 李劍鋒,等.腹膜透析手術在尿毒癥患者腹膜透析治療中的應用[J]. 中國微創外科雜志, 2014, 14(2):126-128.
17.	徐海燕, 蔡莉莉. 腹膜透析早期透析管移位的原因分析和對策[J]. 解放軍護理雜志, 2008, 25(22):46-47.
18.	曹峻, 谷昊, 邰沁文, 等. 腹腔鏡在腹膜透析管置入術中的臨床應用[J]. 中國內鏡雜志, 2010, 16(8):864-866.

1. Guo A, Mujais S. Patient and technique survival on peritoneal dialysis in the United States:evaluation in large incident cohorts[J]. Kidney Int, 2003, 64(Suppl):S3-S1.
2. Crabtree JH, Fishman A. A laparoscopic method for optimal peritoneal dialysis access[J]. Am Surg, 2005, 71(2):135-143.
3. 張浩, 張柯, 姚凱, 等. 腹腔鏡在腹膜透析管堵管中的臨床應用[J]. 中國內鏡雜志, 2008, 14(2):216-224.
4. Tsimoyiannis EC, Siakas P, Glantzounis G, et al. Laparoscopic placement of the Tenckhoff catheter for peritoneal dialysis[J]. Surg Laparosc Endosc Percutan Tech, 2000, 10(4):218-221.
5. Crabtree JH, Fishman A. A laparoscopic approach under local anesthesia for peritoneal dialysis access[J]. Perit Dial Int, 2000, 20(6):757-765.
6. O?ün? G, Tuncer M, O?ün? D, et al. Laparoscopic omental fixation technique versus open surgical placement of peritoneal dialysis catheters[J]. Surg Endosc, 2003, 17(11):1749-1755.
7. Wick G. Continuous quality improvement:a problem solving approach (Part 2) (Educational Supplement)[J]. Nephrol Nurs Today, 1993(3):1-8.
8. 王鑫, 汪濤. 持續質量改進在糾正腹膜透析患者貧血中的作用[J]. 中國中西醫結合腎病雜志, 2004, 5(5):266-269.
9. 駱素平, 董捷. 持續質量提高在腹膜透析相關性腹膜炎防治中的應用[J]. 中國血液凈化雜志, 2008, 7(4):227-229.
10. Figueiredo A, Goh BL, Jenkins S, et al. Clinical practice guidelines for peritoneal access[J]. Perit Dial Int, 2010, 30(4):424-429.
11. Jwo SC, Chen KS, Lee CC, et al. 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]. J Surg Res, 2010, 159(1):489-496.
12. Crabtree JH, Fishman A. Videolaparoscopic implantation of long-term peritoneal dialysis catheters[J]. Surg Endosc, 1999, 13(2):186-190.
13. Crabtree JH, Fishman A. Laparoscopic omentectomy for peritoneal dialysis catheter flow obstruction:a case report and review of the literature[J]. Surg Laparosc Endosc Percutan Tech, 1999, 9(3):228-233.
14. Ogunc G. Minilaparoscopic extraperitoneal tunneling with omentopexy:a new technique for CAPD catheter placement[J]. Perit Dial Int, 2005, 25(6):551-555.
15. Numanoglu A, Rasche L, Roth MA, et al. Laparoscopic insertion with tip suturing, omentectomy, and ovariopexy improves lifespan of peritoneal dialysis catheters in children[J]. J Laparoendosc Adv Surg Tech A, 2008, 18(2):302-305.
16. 郝世軍,王衛軍, 李劍鋒,等.腹膜透析手術在尿毒癥患者腹膜透析治療中的應用[J]. 中國微創外科雜志, 2014, 14(2):126-128.
17. 徐海燕, 蔡莉莉. 腹膜透析早期透析管移位的原因分析和對策[J]. 解放軍護理雜志, 2008, 25(22):46-47.
18. 曹峻, 谷昊, 邰沁文, 等. 腹腔鏡在腹膜透析管置入術中的臨床應用[J]. 中國內鏡雜志, 2010, 16(8):864-866.

West China Medical Journal

Application of Continuous Quality Improvement in Laparoscopic Peritoneal Dialysis Catheter Input

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