Percutaneous versus laparoscopic catheter placement for peritoneal dialysis: a meta-analysis

Abstract Background Peritoneal dialysis (PD) is one of the relatively safe and effective renal replacement therapies for patients with end-stage renal disease (ESRD). There are three main types of PD catheter insertion procedures: open surgery, laparoscopic surgery, and percutaneous insertion. Currently, open surgery is most commonly used in clinical practice, although some hospitals have adopted laparoscopic and percutaneous insertion methods. However, there is still a lack of large-scale studies comparing percutaneous and laparoscopic catheter placement. This study aims to collect and synthesize existing literature data, analyze complications related to PD catheter insertion, and determine the optimal catheter placement method. Methods This Meta-analysis has been registered on the PROSPERO platform (CRD42024509930). Articles published in EMBASE, PubMed, Web of Science, and CNKI were retrieved, statistically analyzed, and reviewed. The statistical software Review Manager version 5.4.1 was used for data analysis. Results A total of nine studies on surgical outcomes and complications were included. The article types included one randomized controlled trial (RCT), one prospective study, and seven retrospective studies. The methodological quality of the 8 included non-randomized studies was assessed using the Newcastle-Ottawa Scale (NOS). The average score was 7.4 points (range: 6 to 8), indicating an overall high study quality. According to existing literature, laparoscopic PD catheter insertion may reduce postoperative bleeding risk but is associated with a longer surgical duration. Additionally, there were no statistically significant differences between laparoscopic and percutaneous catheter insertion methods in terms of the length of hospital stays, early and late complications—including peritonitis, exit-site infections, catheter malfunction and failure, hernia, and dialysate leakage. Conclusion Data analysis indicates that the clinical outcomes of laparoscopic and percutaneous PD catheter insertion are similar. However, large-scale, multicenter studies are still needed to further validate these findings. Clinical trial number Not applicable.