Hasan SUNAR, Orkut GÜÇlÜ, Volkan YÜKSEL, Serhat HÜSEYİN, Suat CANBAZ, Ümit HALICI, Turan EGE

Basilic vein superficialization for hemodialysis vascular access

Amaç: Bu çalışmada, brakiyobazilik arteriyovenöz fistül oluşturulmasında bazilik ven yüzeyelleştirilmesi tekniğinin sonuçları tartışıldı ve deneyimlerimizsunuldu.Çalışma planı: Ocak 2006 - Ocak 2012 tarihleri arasında kliniğimizde bazilik ven yüzeyelleştirilmesi ameliyatı yapılan 170 hasta (74 erkek, 96 kadın; ort.yaş 60.7±9.1 yıl; dağılım 31-83 yıl) çalışmaya alındı.Ameliyat öncesi dönemde tüm hastalara Doppler ultrasonografi uygulandı. Hastaların demografik verileri, matürasyon zamanı ve komplikasyonlar kaydedildi. Ortalama takip süresi 12 ay idi.Bulgular: Ameliyat için dominant olmayan üst ekstremite tercih edildi. Ameliyat olan 170 hastanın 166’sı (%97.6), hemodiyalize girdi. Ortalama matürasyon zamanı 61 gün idi. İki hastada (%1.2) ameliyat sonrasıdönemde masif kanama gelişti. Sekiz hastada (%4.7) erken ameliyat sonrası dönemde yara enfeksiyonu gözlendi. En sık primer başarısızlık nedeni tromboz olup,48 hastada (%28.2) gözlendi. Birinci yılda fistüllerin primer ve sekonder açıklık oranı sırasıyla %77 ve %82 idi. Sonuç: Bazilik ven yüzeyelleştirilmesi ile oluşturulan arteriyovenöz fistüller kronik hemodiyaliz hastalarında, makul ameliyat sonrası komplikasyon oranı ile tatminkarsonuçlar sunmaktadır.

Hemodiyaliz vasküler erişim için bazilik ven yüzeyelleştirilmesi

Background: This study aims to discuss the outcomes ofsuperficialization of basilic vein technique in brachiobasilicarteriovenous fistula formation and to present ourexperience.Methods: Between January 2006 and January 2012,170 patients (74 males, 96 females; mean age 60.7±9.1years; range 31 to 83 years) who underwent basilic veinsuperficialization surgery in our clinic were included. Allpatients were examined under Doppler ultrasonographypreoperatively. Demographic data of the patients,maturation time and complications were recorded. Themean follow-up was 12 months.Results: Non-dominant upper limb was preferred forsurgery. Of the 170 patients who were operated, 166 (97.6%)underwent hemodialysis. The mean maturation time was61 days. Massive bleeding in the postoperative periodoccurred in two patients (1.2%). Wound infection wasobserved in eight patients (4.7%) in the early postoperativeperiod. The most common reason for primary failure wasthrombosis, which was observed in 48 patients (28.2%).The primary and secondary patency rates of the fistulaswere 77% and 82%, respectively at one-year.Conclusion: Arteriovenous fistula formation throughsuperficialization of the basilic vein offers satisfactoryresults in chronic hemodialysis patients with reasonablepostoperative complication rate.

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