ObjectiveTo reduce the incidence of peritoneal dialysis (PD) catheter complications through a continuous quality improvement (CQI) process.
MethodsTwenty-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.
ResultsPD catheter dysfunction decreased from 6.90% to 2.44%. The incidence of leakage decreased from 44.83% to 9.76%.
ConclusionCQI is a useful method to reduce the incidence of postoperative complications of PD catheter in peritoneal dialysis.
ObjectiveTo explore the risk factors affecting catheter obstruction during hyperthermic intraperitoneal chemotherapy (HIPEC). MethodsBased on the inclusion and exclusion criteria, the patients who underwent HIPEC at the First Affiliated Hospital of Xi’an Jiaotong University from February 2023 to December 2023 were retrospectively collected. The data were analyzed using univariate analysis and machine learning. The statistical significance was defined as α=0.05. ResultsA total of 210 patients underwent HIPEC and met the inclusion criteria were included, 51 (24.3%) experienced catheter obstruction. The univariate analysis revealed that the inflow-outflow temperature gradient of the perfusate (ΔT of the perfusate), flow velocity of perfusate, neoadjuvant chemotherapy exposure, hypertension status, surgical approach, and HIPEC catheter length were associated with catheter obstruction (P<0.05). Subsequently, combining the results of the univariate analysis with feature values screened by machine learning, the following factors were selected, including HIPEC catheter length, ΔT of the perfusate, flow velocity of perfusate, age, gender, neoadjuvant chemotherapy exposure, fibrinogen level, hypertension status, surgical approach, and blood transfusion. A predictive model for HIPEC catheter obstruction based on these features was established, achieving an area under the receiver operating characteristic curve (95%CI) of 0.825 (0.757, 0.893). ConclusionThis study preliminarily identifies key factors influencing the incidence of catheter obstruction during HIPEC treatment, such as ΔT of the perfusate, flow velocity of perfusate, neoadjuvant chemotherapy exposure, surgical approach, HIPEC catheter length, and hypertension, continuously monitoring these factors, thereby reducing the risk of catheter obstruction.
ObjectiveTo understand the current situation and factors affecting tube blockage (non-mechanical) during hyperthermic intraperitoneal chemotherapy (HIPEC). MethodsAccording to the inclusion and exclusion criteria, the patients with malignant tumors who underwent HIPEC in the Department of Gastroenterology of West China Hospital of Sichuan University from May 2019 to May 2021 were retrospectively gathered. The information about the patient and the occurrence of occlusion during HIPEC were obtained by consulting electronic medical records and perfusion records. The logistic regression analysis was performed to analyze the factors influencing non-mechanical tube blockage during HIPEC. ResultsA total of 240 patients with malignant tumors were gathered. During HIPEC, the non-mechanical tube blockage occurred in 88 patients with malignant tumors, with the incidence of 36.7%. The multivariate analysis results by logistic regression showed that the probabilities of non-mechanical tube blockage during HIPEC were higher in the patients with age≥65 years (OR=2.142, P=0.016), diabetes mellitus (OR=2.326, P=0.007), perfusion speed of 300–450 mL/min (OR=2.778, P=0.001), ascites (OR=2.192, P=0.020), and PCI ≥20 points (OR=4.380, P<0.001). ConclusionsPatients with malignant tumors treated with HIPEC are prone to non-mechanical tube blockage. The patients with middle-aged and elderly, diabetes, low perfusion speed, ascites, and high PCI score need to be of great concern, so as to prevent and deal with tube blockage in time.
