Laparoscopic Scopic Versus Traditional Peritoneal Dialysis Catheter Insertion:a Meta Analysis

Objective:To compare the catheter-related complication as well as catheter survival between laparoscopic and open surgery in peritoneal dialysis catheter insertion.Methods:We collected RCTs as well as observational studies on comparing these two PDC insertion technique by carrying out a meta-analysis based on data by searching Pubmed, Elsevier Sciencedirect, Cochrane Library, Springer and CNKI. Futher screening was done by two independent researchers and one superviser to select literatue following PICO principles. Meta-analysis was carried out by RevMan5.3. Finally, we graded all the results by GRADEprofiler3.6.Results:5 randomized controlled trials and 14 cohort studies were identified. Meta-analysis showed laparoscopic catheter insertion was superior to traditional surgery in terms of controlling catheter migration (OR 0.22,95% CI 0.13 to 0.39; p<0.00001)and catheter survival rate (1-year survival rate:OR 2.64,95% CI 1.69 to 4.14,p<0.0001; 2-year survival rate:OR 2.18,95%,CI 1.48 to 3.21,p<0.0001), but slightly increase the risk of bleeding (OR 2.13,95% CI 1.07 to 4.23,p=0.03). The two groups were not significantly different in other catheter-related complications. As regards the quality of the analysis,only the migration analysis ranked A-level, while the rest fell into Class B or C. The overall research quality is moderate.Conclusion:Laparoscopic surgery is superior to traditional surgery on reducing catheter migration and prolonging catheter survival rate according to our analysis.