Comparative outcomes of image-guided percutaneous catheterisation versus direct visualisation catheterisation for peritoneal dialysis: a meta-analysis

This meta-analysis was conducted in accordance with the Preferred Reporting Project for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines [29, 30]. The databases of PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched for articles up to July 16, 2024. The search methodology followed the PICOS principle and employed a combination of MeSH terms and unrestricted textual phrases. The search method utilised involved the amalgamation of the terms "Peritoneal Dialysis," "catheter," "direct visualisation catheterisation" and "image-guided percutaneous catheterisation". Inclusion criteria: (1) Patients with ESRD who underwent PD catheter placement; (2) Interventional group: patients received IGPC, comprising percutaneous puncture techniques utilising X-ray fluoroscopy or ultrasound guidance; (3) Control group: patients received DVC, comprising conventional open surgery or catheter placement techniques performed under laparoscopy; (4) At least one of the following outcomes was reported: peritonitis, tunnel infection, exit-site infection, catheter dysfunction, bleeding, catheter leakage, hernia, catheter removal, and one-year PD catheter survival. (5) Study design: RCT, prospective study, or retrospective study. Exclusion criteria: (1) Other types of articles, including conferences, abstracts, yearbooks, case reports, journals, letters, reviews, meta-analyses, editorials, pharmaceutical interventions, animal studies, and protocols; (2) Not relevant; (3) Duplicate patient cohort; (4) Inability to extract data for meta-analysis. EndNote (Version 20; Clarification Analysis) was utilised to oversee the selection of retrieved studies, including the elimination of duplicates. All study results were evaluated utilising Review Manager 5.3 (Cochrane Collaboration, Oxford, UK). The odds ratio (OR) accompanied by a 95% confidence interval (CI) was employed to compare the binary variables. Cochrane Q p-values and I2statistics were employed to assess heterogeneity in all meta-analyses. The potential for publication bias was evaluated through a visual examination of the funnel plot. Sensitivity analyses were performed by sequentially excluding each study to assess the impact of individual studies on the aggregated results and to evaluate the reliability of the findings. The research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.