Conventional method versus no-touch technique in radiocephalic arteriovenous fistula

Abstract

Objectives The aim was to evaluate the feasibility of no-touch technique (NTT) in radiocephalic fistula and to compare conventional method with NTT in the creation of radiocephalic fistula regarding the rate of complication, failure of maturity, and patency rate. Background Radiocephalic fistula is consider the first fistula to be created; however, it has a higher failure rate. NTT represents an attractive option for performing radiocephalic fistula. Patients and methods This is a prospective comparative study done on 80 patients with end-stage renal disease who were prepared for dialysis. Half of the patients were operated by NTT and the other half by conventional technique at vascular surgery unit in department of general surgery, Menoufia University Hospital, between November 2016 and April 2018. Results A total of 80 patients who had end-stage renal disease underwent radiocephalic arteriovenous fistula: half of them with conventional (Brescia and Cimino) technique and the other half with no-touch method. The primary failure rate in NTT (7.5%) was not statistically significantly different from the conventional method (17.5%). The primary patency also had no statistically significant difference during the follow-up period at 1 and 3 months between the two methods, but NTT at 6 months had better primary and secondary patency rates than conventional method. There was no difference in infection and pseudoaneurysm rates between the two methods. Conclusions The results of this study indicate that NTT can be used for primary radiocephalic fistula surgery and showed better results than conventional method in the long-term follow-up.