Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
Semin Dial. 2007 Sep-Oct;20(5):455-7.

Does the surgeon's experience impact on radiocephalic fistula patency rates?

Author information

  • 1South West Thames Surrey and Sussex Renal Transplant Unit, St. George's Healthcare NHS Trust, London, United Kingdom.

Abstract

Establishing successful long-term hemodialysis access remains a major challenge. The primary aims of this study were to determine whether primary success and primary and secondary patency rates of a series of consecutive radio-cephalic fistulae (RCF) were affected by the experience of the surgeon. The secondary aims were to assess complications, and to compare results with patency rates from the literature. All native fistulae (AVF) created in our unit between January 1, 2002 and December 31, 2005 were analyzed retrospectively. The RCF were identified and divided into group A (RCF fashioned by the consultant surgeon), and group B (fashioned by the junior surgeons within the unit). Demographic characteristics, risk factors, primary success rate (patent fistula at discharge), and primary and secondary patency rates were compared between each group using chi-squared test. During this period, 552 AVF were created. Of the 195 RCF, there were 153 fistulae in group A and 42 in group B. Median follow-up was 22 months for both groups. There was no difference with regards to age, sex ratio, prevalence of diabetes, and cardiovascular disease. The primary success rate in group A and B was 94.2% and 81%, respectively (p < 0.01). Primary and secondary patency rates at 22 months were 80%, 93%* and 74%, 81%* in group A and B, respectively (*p < 0.025). Even within group B, these results compare very favorably with the published literature. These results suggest that the placement of a RCF should be performed by the most experienced member of a team dedicated to vascular access creation or at least under his supervision.

Comment in

PMID:
17897253
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for Blackwell Publishing
    Loading ...
    Write to the Help Desk