Peritoneal catheter fixation versus nonfixation in open surgery

BACKGROUND: The objective of this study was to compare the advantages and disadvantages of peritoneal dialysis (PD) catheter fixation versus nonfixation in open surgery for PD catheter placement. METHODS: We searched the PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases from their inception to March 1, 2025. Eligible studies comparing PD catheter fixation with nonfixation in open surgery were included. The data were analyzed using Review Manager Version 5.3 and Stata Version 14. RESULTS: Thirteen studies were included in the meta-analysis. A total of 648 patients were included in the PD catheter fixation group, and 627 patients were included in the PD catheter nonfixation group. Compared with PD catheter nonfixation, PD catheter fixation reduced the incidence of catheter displacement during open surgery (odds ratio [OR] 0.08, 95% confidence interval [CI] 0.04-0.16; P < .00001). However, there were no differences between the catheter fixation and catheter nonfixation groups concerning catheter malfunction without catheter displacement (OR 1.52, 95% CI 0.29-8.00, P = .62), omentum wrapping (OR 0.36, 95% CI 0.11-1.18, P = .09), infection (OR 0.95, 95% CI 0.51-1.78, P = .87), bleeding (OR 2.78, 95% CI 0.11-69.74, P = .53), infusion pain (OR 0.42, 95% CI 0.15-1.16, P = .10), or hernia (OR 0.66, 95% CI 0.11-4.07, P = .65). In addition, the operating time in the catheter fixation group was longer than that in the catheter nonfixation group (mean difference 4.18, 95% CI 1.42-6.94; P = .003). CONCLUSION: PD catheter fixation increased the operating time, but it reduced the incidence of catheter displacement and did not increase other complications in open surgery. PD catheter fixation is safe and effective in open surgery.