The Japanese Journal of Clinical Dialysis Vol.20 No.11(5-2)

Theme New Development in CAPD Therapy
Title Encapsulating peritoneal sclerosis : surgical management
Publish Date 2004/10
Author Hideki Kawanishi Akane Foundation Tsuchiya General Hospital
[ Summary ] Appropriate treatment according to disease stage is very important in encapsulating peritoneal sclerosis (EPS) treatment. Therefore, when examining a peritoneal dialysis (PD) patients complaining of gastrointestinal symptoms, the possibility of EPS must be kept in mind. Basic therapeutic tactics for EPS include the appropriate use of corticosteroids. If a state of bowel obstruction persists, laparotomy and enterolysis should be performed to obtain a complete cure. In our hospital, 52 EPS patients were treated surgically, and the state of bowel obstruction was successfully improved in all these patients, except 2 patients who died of bowel perforations. At present, post-operative recurrence of EPS is the major problem, and was experienced in 8 cases in our series. In all recurrent cases it was possible to achieve full recovery with repeated surgery. It is currently recognized that EPS is not a fatal complication associated with PD. Further pathophysiological investigation is required to solve problems associated with EPS.
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