Objective To compare the efficacy and safety of open and low-position two-port laparoscopic technique for peritoneal dialysis catheterization. Methods A total of 639 patients with end-stage renal disease were retrospectively analyzed, who received catheter and peritoneal dialysis therapy from June 2016 to December 2019 in the First Affiliated Hospital of Zhejiang University. For the placement of peritoneal dialysis catheters, 147 patients underwent low-position two-port laparoscopic surgery (group A) and 292 patients were by open surgical method (group B). The general condition before operation, perioperative condition, postoperative complications and outcomes were compared between the two groups. Results The operation time (t=-21.543, P＜0.001) and hospitalization time (t=-2.398,P=0.017) in group A were shorter than those in group B, while operative hemorrhage (t=-0.011，P=0.991), postoperative pain (t=-1.650，P=0.100), onset time of peritoneal dialysis (t=-0.211，P=0.833)and hospitalization expenses (t=-1.739，P=0.083) showed no difference. the incidence of catheter malposition (χ2=7.516, P=0.006) and bloody effluent (χ2=4.675, P=0.031)in group A were significantly lower than those in group B, while the other complications such as catheter occlusion (χ2=0.762, P=0.383), omentum wrapping (χ2=0.010, P=0.921), dialysate leakage (χ2=0.182, P=0.544), organ injury (χ2=0.299, P=0.770), hernia, hydrothorax (χ2=0.003, P=0.955), and peritonitis (within 2 weeks) (χ2=0.182, P=0.670)showed no difference. There was no tunnel infection event within 2 weeks in both groups. patients in group A had a favorable catheter technique survival rate compared with group B (Log-rank χ2=4.696, P=0.030). Conclusions Our low-position two-port laparoscopic technique is a simple and safe procedure. This procedure can shorten the operation time, reduce the possibility of migration, trauma and complications, and improved the catheter technique survival rate without additional costs. This technique is worthy of clinical application.
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