The impact of training on outcomes in primary vascular access surgery

Annals of the Royal College of Surgeons of England
A R WealeD C Mitchell

Abstract

There is evidence that the outcome of arteriovenous fistula surgery is dependent on the surgeon performing the operation. Vascular access surgery provides excellent technical training for surgical trainees. The effect of surgical trainees on the outcome of fistulas was evaluated. The grade of the main operator for all first attempted (primary) upper limb arteriovenous fistulas, between February 1998 and August 2001, was identified. Median follow-up was 18.0 months (IQR, 6.5-30.1 months). Successful use of fistula for dialysis, fistula patency and survival were assessed. 441 primary fistulas were formed in the study period. Median age was 67.5 years (IQR, 54.0-75.2 years). 71% of all fistulas were formed at the wrist. Trainees performed 31.1% of all operations. The two groups (trainees and consultants) were well matched for age, sex, diabetes, and fistula type. Only 70.5% of patients proceeded to long-term haemodialysis. There were no significant differences in the successful use of AVF for dialysis or patency rates between the two groups. One and two year fistula survival in this group was 87.7% and 78.3% for trainees and 80.8% and 71.1% for consultants (P = 0.288 log rank). Surgical trainees can perform primary AVF surgery wit...Continue Reading

Citations

Oct 22, 2010·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·David A GoodkinRajiv Saran
Jun 19, 2010·ANZ Journal of Surgery·Diana Tam, Jonathan Wheeler
Sep 24, 2015·Nefrología : publicación oficial de la Sociedad Española Nefrologia·Branko FilaLada Zibar
Feb 6, 2008·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·Z GundeviaT Wilmink
Nov 22, 2005·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·C P Gibbons
Sep 18, 2013·The Journal of Vascular Access·Ahmed M El-SharkawyTimothy E Rowlands
Sep 10, 2014·The Journal of Vascular Access·Damian G McGroganMel Field
Feb 17, 2015·The Journal of Vascular Access·Miltos K LazaridesEfstratios I Georgakarakos

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