Comparison between the ‘pull technique’ and open surgery for peritoneal catheter removal in Chinese patients on peritoneal dialysis

Background: The removal techniques for peritoneal dialysis (PD) catheters are open surgical dissection (OD) and the ‘pull technique’ (PT). The latter is limitedly used because of uncertainty about its feasibility and safety. This study aimed to compare the outcomes and complications between the two techniques. Methods: This retrospective study included patients who underwent PD catheter removal from January 2015 to January 2021 in four PD centres in China. The patients were grouped according to the different removal techniques and were followed up to observe the potential complications. Results: The demographic characteristics of patients in the PT ( n = 68) and OD ( n = 44) groups showed no significant difference. The indications for PD catheter removal were similar between the two groups, except for a higher frequency of peritonitis in the OD group ( p = 0.010). In the PT group, the main complications were broken catheter (7.4%), superficial cuff infection (4.8%) and subcutaneous bleeding (4.8%). In the OD group, the main complications were death (9.1%) and subcutaneous bleeding (4.6%). Conclusion: PT might be a safe and reliable technique for PD catheter removal compared to OD. Considering its simple and non-invasive nature, PT should be recommended as the alternative to OD in suitable PD patients.