Peritoneal catheter fixation versus nonfixation in open surgery: A meta-analysis.
Weigang Tang, Wei Jiang, Zhixia Wang et al.
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In 30 seconds
This meta-analysis compared fixation with nonfixation of peritoneal dialysis (PD) catheters placed by open surgery. Thirteen studies included 648 patients in the fixation group and 627 in the nonfixation group. Fixation was associated with substantially lower odds of catheter displacement (OR 0.08, 95% CI 0.04-0.16; P < .00001), while operating time was longer (mean difference 4.18, 95% CI 1.42-6.94; P = .003). The analysis found no statistically significant differences in the other reported complications, including infection, bleeding, and hernia.
Key findings
- Catheter displacement was less frequent with fixation than nonfixation (OR 0.08, 95% CI 0.04-0.16; P < .00001).
- Operating time was longer with fixation (mean difference 4.18, 95% CI 1.42-6.94; P = .003).
- No statistically significant group differences were found for malfunction without displacement, omentum wrapping, infection, bleeding, infusion pain, or hernia.
Why it matters
Catheter displacement can compromise PD access, so the marked association with lower displacement is relevant when considering open catheter placement. The findings also highlight a trade-off: fixation took longer, while the analysis did not detect differences in other reported complications. These results help frame the procedural choice but do not establish that fixation improves broader patient outcomes.
What to keep in mind
The meta-analysis combined 13 studies; the abstract does not describe their design or quality. Several complication estimates have wide confidence intervals, limiting precision.