Hamdi TOKÖZ, Fuat BİLGEN, Ayça ÖZGEN, İsmail ORAL HASTAOĞLU

No-touch’a karşı konvansiyonel teknik kullanılarak oluşturulan radiosefalik arteriyovenöz fistüllerin bir yıldaki açıklık oranlarının karşılaştırılması

Amaç: Bu çalışmada perivenöz vasküler dokuların korunması yoluna karşı konvansiyonel teknik kullanılarak hazırlanan radiosefalik arteriyovenöz fistüllerin açıklık oranları karşılaştırıldı. Çalışma planı: Çalışmaya radiosefalik arteriyovenöz fistül yapımı uygulanan toplam 169 hasta (107 erkek, 62 kadın; ort. yaş 59.5 yıl; dağılım, 39-87 yıl) dahil edildi. Doksan beş hastada konvansiyonel yöntem uyarınca sefalik damarı çevreleyen dokular çıkarılırken 74 hastada damar hazırlanması için perivenöz vasküler dokuları koruyan no-touch tekniğinden yararlanıldı. Hastalar arteriyovenöz fistüllerin bir yıldaki primer ve sekonder açıklık oranlarının karşılaştırılması için takip edildi. Bulgular: Yirmi iki hastada birinci yıl içinde fistül hatası gelişerek no-touch ve konvansiyonel gruplar için sırasıyla %90.5’e karşı %84.2 primer açıklık oranına neden oldu (p=0.225). Benzer şekilde, sekonder açıklık oranları no-touch ve konvansiyonel gruplar için sırasıyla %94.6’ya karşı %93.7 idi (p=0.803). İki grup primer ve sekonder açıklık oranları bakımından farklı değildi. Sonuç: Bu çalışmanın bulguları bir yıldaki arteriyovenöz fistül açıklığı açısından konvansiyonel yöntemlerle karşılaştırıldığında no-touch tekniği lehine değildi.

Comparison of the one-year patency rates of radiocephalic arteriovenous fistulas created using no-touch versus conventional technique

Background: This study aims to compare the patency rates ofradiocephalic arteriovenous fistulas prepared preserving theperivenous vascular tissues versus those prepared using theconventional technique.Methods: A total of 169 patients (107 males, 62 females;mean age 59.5 years; range, 39 to 87 years) who underwent aradiocephalic arteriovenous fistula construction were includedin this study. In 95 patients, the tissues surrounding the cephalicvein were stripped off as per the conventional method, while theno-touch technique preserving the perivenous vascular tissueswas utilized for vein harvesting in 74 patients. Patients werefollowed-up to compare primary and secondary patency rates ofthe arteriovenous fistulas at one year.Results: Fistula failure developed in 22 patients within the firstyear resulting in primary patency rates of 90.5% versus 84.2%for the no-touch and the conventional groups, respectively(p=0.225). Likewise, secondary patency rates were 94.6% versus93.7% for the no-touch and the conventional groups, respectively(p=0.803). The two groups did not differ with regards to primaryor secondary patency rates.Conclusion: Findings of this study were not in favor of theno-touch technique compared to the conventional methods interms of arteriovenous fistula patency at one year.

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