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지속성 외래 복막투석도관 삽입술시 유착방지제의 효과

The Effect of an Anti-adhesion Agent in Continuous Ambulatory Peritoneal Dialysis (CAPD) Catheter Insertion Operation

대한외과학회지
2010년 78권 2호 p.71 ~ p.76
김기환 ( Kim Ki-Hwan ) - 동아대학교 의과대학 외과학교실

노영훈 ( Roh Young-Hoon ) - 동아대학교 의과대학 외과학교실
김영훈 ( Kim Young-Hoon ) - 동아대학교 의과대학 외과학교실
정갑중 ( Jung Ghap-Joong ) - 동아대학교 의과대학 외과학교실
안원석 ( An Won-Suk ) - 동아대학교 의과대학 신장내과학교실
김성은 ( Kim Sung-Eun ) - 동아대학교 의과대학 신장내과학교실
김기현 ( Kim Ki-Hyun ) - 동아대학교 의과대학 신장내과학교실

Abstract

Purpose: Continuous ambulatory peritoneal dialysis (CAPD) is an important method of performing renal replacement therapy in patients with chronic renal failure. A significant complication of CAPD is malfunction of the catheter because of catheter adhesion that leads to catheter malposition. So we evaluated the effect of an anti-adhesive agent called Guardix-Sol?.

Methods: We prospectively evaluated the clinical results of 78 patients who had received CAPD catheter insertion from Sep. 2007 to May 2009. A test group of 34 patients used the anti-adhesion agent and a control group of 44 patients did not use it. All the procedures were standardized and performed by a single surgeon.

Results: The patients consisted of 49 males and 29 females. The common reasons for CAPD insertion were diabetic nephropathy (47 patients) and hypertension (20 patients). Fifteen patients needed reposition operations during their postoperative course, which were done under spinal anesthesia. Out of 15 patients, 3 were from the test group (Guardix-Sol? group) and 12 from the control group (P=0.0526). All the repositioned patients had a malpositioned catheter because the greater omentum had adhered to the catheter, except for one patient in each group (P=0.0315).

Conclusion: Using an anti-adhesive agent for CAPD insertion is an effective method to reduce the incidence of greater omental adhesion. So the rate of reoperation cases for catheter repositioning is decreased.

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학술진흥재단(KCI) KoreaMed 대한의학회 회원 
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