Patient oriented management for the creation of arteriovenous fistula for hemodialysis
Tarık Zafer Nursal
Medline Adana Hospital, Department of General Surgery, Adana, Turkey
Objective: Hemodialysis access is of paramount importance for end-stage renal failure (ESRF) patients. Creation and maintenance of arteriovenous fistula (AVF) by a dedicated team increases the success and duration of the hemodialysis. The aim of this study is to report a patient oriented standardized surgical technique performed by a single surgeon on the success of AVF creation.
Material and Methods: A single surgeon performed all AVF operations. The records of all patients who were operated for AVF creation without using synthetic grafts through a 3 year period (2009-2011) were included. The patients were examined and operated on by a previously defined standard protocol.
Results: A total of 221 procedures were done for 209 patients. The mean age was 65±11,4 years. Immediate function rate was 95.9% (n=212). Follow-up was possible for 182 patients (82.3%). For an average follow-up time of 11,3 months, the death rate was 20.8% (n=38) and the rate of AVF patency was 73.7% (n=134).
Conclusion: Sustaining patency of AVF is difficult in these systemically deranged patients. A focused approach by a dedicated team will increase the success rate.
Keywords: Arteriovenous fistula, hemodialysis, surgery