Videoscopic Surgery for Arteriovenous Hemodialysis Access
10.5090/kjtcs.2020.53.1.28
- Author:
Hyuncheol JEONG
1
;
Miju BAE
;
Sung Woon CHUNG
;
Chung Won LEE
;
Up HUH
;
Min Su KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Busan, Korea
- Publication Type:Clinical Research
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2020;53(1):28-33
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:When an arteriovenous fistula (AVF) is created using the basilic or deep cephalic vein, it is additionally necessary to transfer the vessels to a position where needling is easy; however, many patients develop wound-related postsurgical complications due to the long surgical wounds resulting from conventional superficialization of a deep AVF or basilic vein transposition. Thus, to address this problem, we performed videoscopic surgery with small surgical incisions.
Methods:Data from 16 patients who underwent additional videoscopic radiocephalic superficialization, brachiocephalic superficialization, and brachiobasilic transposition after AVF formation at our institution in 2018 were retrospectively reviewed.
Results:Needling was successful in all patients. No wound-related complications occurred. The mean vessel size and blood flow of the AVF just before the first needling were 0.73±0.16 mm and 1,516.25±791.26 mL/min, respectively. The mean vessel depth after surgery was 0.26±0.10 cm. Percutaneous angioplasty was additionally performed in 25% of the patients. Primary patency was observed in 100% of patients during the follow-up period (262.44±73.49 days).
Conclusion:Videoscopic surgery for AVF dramatically reduced the incidence of postoperative complications without interrupting patency; moreover, such procedures may increase the use of native vessels for vascular access. In addition, dissection using a videoscope compared to blind dissection using only a skip incision dramatically increased the success rate of displacement by reducing damage to the dissected vessels.
