Minimally invasive basilic vein transposition in the arm or forearm for autogenous haemodialysis access: A less morbid alternative to the conventional technique

Objective: To devise a minimally invasive, less morbid yet effective alternative technique for basilic vein transposition (BVT) in the arm/forearm and to compare perioperative outcomes with the conventional technique. Patients and methods: Patients undergoing BVT in the last two years (June 2013 to...

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Autores principales: Ankush Jairath, Abhishek Singh, Ravindra Sabnis, Arvind Ganpule, Mahesh Desai
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Publicado: Taylor & Francis Group 2017
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spelling oai:doaj.org-article:009f2f1c056c46f8a123baba31d71da52021-12-02T09:51:22ZMinimally invasive basilic vein transposition in the arm or forearm for autogenous haemodialysis access: A less morbid alternative to the conventional technique2090-598X10.1016/j.aju.2017.01.004https://doaj.org/article/009f2f1c056c46f8a123baba31d71da52017-06-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2090598X17300293https://doaj.org/toc/2090-598XObjective: To devise a minimally invasive, less morbid yet effective alternative technique for basilic vein transposition (BVT) in the arm/forearm and to compare perioperative outcomes with the conventional technique. Patients and methods: Patients undergoing BVT in the last two years (June 2013 to June 2015) were included in the study and the results were analysed. All patients were preoperatively evaluated using colour Doppler ultrasonography performed by the operating surgeon himself. For minimally invasive BVT, two or three small 1–2 cm incisions were made to completely mobilise the basilic vein, transposed in an anterolateral arm/forearm tunnel, and then anastomosed to the brachial or radial artery in the forearm and arm, respectively. The incision in the conventional technique was along the full length of the basilic vein, with the rest of the procedure remaining the same. Complications, pain, analgesic use, maturation and primary patency rates were compared between the techniques. Results: In all, 30 patients underwent minimally invasive BVT and 34 patients underwent conventional BVT, with mean age of 52 and 55 years, respectively. The complications of wound haematoma (one vs four) and wound infection/dehiscence (two vs six) were less common in the minimally invasive BVT group compared to the conventional group. The analgesic requirement and visual analogue scale pain score was significantly less in the minimally invasive BVT group. All other variables assessed, such as maturation and primary patency rate at 1 year, were not significantly different between the groups. Conclusion: Minimally invasive dissection of the basilic vein for vascular access transposition is a safe, reliable procedure with patency and functional outcomes comparable with those of conventional BVT.Ankush JairathAbhishek SinghRavindra SabnisArvind GanpuleMahesh DesaiTaylor & Francis GrouparticleBasilic veinBrachial arteryMinimally invasiveFistulaTranspositionDiseases of the genitourinary system. UrologyRC870-923ENArab Journal of Urology, Vol 15, Iss 2, Pp 170-176 (2017)
institution DOAJ
collection DOAJ
language EN
topic Basilic vein
Brachial artery
Minimally invasive
Fistula
Transposition
Diseases of the genitourinary system. Urology
RC870-923
spellingShingle Basilic vein
Brachial artery
Minimally invasive
Fistula
Transposition
Diseases of the genitourinary system. Urology
RC870-923
Ankush Jairath
Abhishek Singh
Ravindra Sabnis
Arvind Ganpule
Mahesh Desai
Minimally invasive basilic vein transposition in the arm or forearm for autogenous haemodialysis access: A less morbid alternative to the conventional technique
description Objective: To devise a minimally invasive, less morbid yet effective alternative technique for basilic vein transposition (BVT) in the arm/forearm and to compare perioperative outcomes with the conventional technique. Patients and methods: Patients undergoing BVT in the last two years (June 2013 to June 2015) were included in the study and the results were analysed. All patients were preoperatively evaluated using colour Doppler ultrasonography performed by the operating surgeon himself. For minimally invasive BVT, two or three small 1–2 cm incisions were made to completely mobilise the basilic vein, transposed in an anterolateral arm/forearm tunnel, and then anastomosed to the brachial or radial artery in the forearm and arm, respectively. The incision in the conventional technique was along the full length of the basilic vein, with the rest of the procedure remaining the same. Complications, pain, analgesic use, maturation and primary patency rates were compared between the techniques. Results: In all, 30 patients underwent minimally invasive BVT and 34 patients underwent conventional BVT, with mean age of 52 and 55 years, respectively. The complications of wound haematoma (one vs four) and wound infection/dehiscence (two vs six) were less common in the minimally invasive BVT group compared to the conventional group. The analgesic requirement and visual analogue scale pain score was significantly less in the minimally invasive BVT group. All other variables assessed, such as maturation and primary patency rate at 1 year, were not significantly different between the groups. Conclusion: Minimally invasive dissection of the basilic vein for vascular access transposition is a safe, reliable procedure with patency and functional outcomes comparable with those of conventional BVT.
format article
author Ankush Jairath
Abhishek Singh
Ravindra Sabnis
Arvind Ganpule
Mahesh Desai
author_facet Ankush Jairath
Abhishek Singh
Ravindra Sabnis
Arvind Ganpule
Mahesh Desai
author_sort Ankush Jairath
title Minimally invasive basilic vein transposition in the arm or forearm for autogenous haemodialysis access: A less morbid alternative to the conventional technique
title_short Minimally invasive basilic vein transposition in the arm or forearm for autogenous haemodialysis access: A less morbid alternative to the conventional technique
title_full Minimally invasive basilic vein transposition in the arm or forearm for autogenous haemodialysis access: A less morbid alternative to the conventional technique
title_fullStr Minimally invasive basilic vein transposition in the arm or forearm for autogenous haemodialysis access: A less morbid alternative to the conventional technique
title_full_unstemmed Minimally invasive basilic vein transposition in the arm or forearm for autogenous haemodialysis access: A less morbid alternative to the conventional technique
title_sort minimally invasive basilic vein transposition in the arm or forearm for autogenous haemodialysis access: a less morbid alternative to the conventional technique
publisher Taylor & Francis Group
publishDate 2017
url https://doaj.org/article/009f2f1c056c46f8a123baba31d71da5
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AT abhisheksingh minimallyinvasivebasilicveintranspositioninthearmorforearmforautogenoushaemodialysisaccessalessmorbidalternativetotheconventionaltechnique
AT ravindrasabnis minimallyinvasivebasilicveintranspositioninthearmorforearmforautogenoushaemodialysisaccessalessmorbidalternativetotheconventionaltechnique
AT arvindganpule minimallyinvasivebasilicveintranspositioninthearmorforearmforautogenoushaemodialysisaccessalessmorbidalternativetotheconventionaltechnique
AT maheshdesai minimallyinvasivebasilicveintranspositioninthearmorforearmforautogenoushaemodialysisaccessalessmorbidalternativetotheconventionaltechnique
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