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과거 동정맥루 수술경력이 새로운 동정맥루의 개존율에 미치는 영향

Other Titles
 The Effect of Reoperation on the Patency Rate of Arteriovenous Fistula for Hemodialysis 
Authors
 주영근  ;  김명수  ;  이재명  ;  최승옥  ;  한병근 
Citation
 JOURNAL OF THE KOREAN SURGICAL SOCIETY , Vol.64(3) : 243-250, 2003 
Journal Title
 JOURNAL OF THE KOREAN SURGICAL SOCIETY 
ISSN
 1226-0053 
Issue Date
2003
MeSH
Arteriovenous fistula (AVF) ; Patency rate ; Reoperation ; 동정맥루 ; 개존율 ; 재수술
Keywords
Arteriovenous fistula (AVF) ; Patency rate ; Reoperation ; 동정맥루 ; 개존율 ; 재수술
Abstract
Purpose: We designed this study to find out the risk factors affecting the patency rate after creation of an arteriovenous fistula (AVF) for hemodialysis. Methods: Between March 1997 and December 2001, a total of 397 AVF operations in 314 patients were performed by a single surgeon using the same surgical technique and principles. One hundred and forty cases (35.3%) were reoperations due to previous AVF failure. Artificial vessels (=PTFE, polytetrafluoroethylene) were used for the AVF in 39 cases (9.8%). The sex, age, diabetes mellitus, previous operation history and type of dialysis center were considered as a possible risk factors affecting the patency rate. Results: After a mean follow-up of 18.3 months, there were 63 cases of patient death, 15 of kidney transplantation, and 104 of AVF failure identified. The overall patency rates of 1, 2 and 3 year were 76.2, 70.9, and 66.9%, respectively. From the multivariate analysis, the previous operation history was the only significant factor affecting the patency rate of AVF (P=0.001, odd ratio=2.58). Although the diabetic patient (odd ratio=1.43) and artificial vessel groups (odd ratio=1.678) showed high odd ratios, these factors were not statistically significant (P>0.05). From the univariate analysis, the reoperation cases also showed a significantly inferior patency rate compared to the first operation cases (1 year patency rate was 65.2% and 83.7%, P=0.001). However, the diabetes and types of vessel showed no significant differences in patency rates. Conclusion: A reoperation of an AVF creation was the most significant risk factor affecting the patency rate after its original creation. The first attempt AVF creations showed-favorable patency rates. To improve the overall patency rate of an AVF creation, a more delicate preoperative study and accurate surgical technique will be required at the time of the first AVF operation.
Files in This Item:
T200302841.pdf Download
DOI
OAK-2003-00224
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/113384
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