Midterm results of arteriovenous fistula patency at Dong Nai General Hospital

Abstract

Background: End-stage renal disease (ESRD) has dramatically increased in number and hemodialysis remains the main therapy. Arteriovenous fistula plays a critical role for dialysis patients. 
 Materials and Methods: We retrospectively reviewed the medical records of AVF operated in Dong Nai General Hospital (between 09/2017 and 08/2020). Outcomes were compared between two groups: With and without preoperative vascular lập bản đồ to assess the role of this method. Learning curves were analyzed based on the trend of mean operative time and surgical success rate over time, and the number of operations required to overcome the learning curve was calculated with the CUSUM method. 
 Results: The study group consisted of 158 patients, with a mean age of 54.76 ± 26. Male/ female rate was nearly 1:1. Short-term outcomes: Success rate was 87.3%, failure rate was 12.7%, reoperation rate was 7.6%. At 3 months, 6 months, and 9 months follow–up, the AVF patency was 86.70%, 84.18%, and 80.38%, respectively. Vascular lập bản đồ has a better trend of the short-term outcome (83.8% vs. 90.4%; P = 0.231), as well as AVF patency at 3 months, 6 months, 9 months (83.54% vs. 89.87%; P = 0.174), (79.75% vs. 88.61%; P = 0.066) and (75.95% vs. 84.08%; P = 0.077), respectively. However, the difference was not significant. In case of preoperative vascular lập bản đồ, the number of operations required to overcome the learning curve was 75 cases. 
 Conclusion: Arteriovenous fistula surgery at Dong Nai General Hospital has a good short term and mid-term outcome. Preoperative vascular mapping seemed to improve the outcomes.