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A Comparative Study of Continuous Versus Interrupted Suturing Technique in Creating a Vascular Access for Hemodialysis: An Institutional-Based Experience

Background Arteriovenous fistulas (AVFs) are considered the first and best access for patients with end-stage renal disease who need permanent vascular access for hemodialysis over arteriovenous grafts and central venous catheters for reasons that have been well-established. Poor early patency rates...

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Autores principales: Roy, Siddhant, Bhat, Mahakshit, Ahmed, Nisar, Sharma, Lokesh, Mathur, Rajeev, Tomar, Vinay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10428183/
https://www.ncbi.nlm.nih.gov/pubmed/37593256
http://dx.doi.org/10.7759/cureus.42004
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author Roy, Siddhant
Bhat, Mahakshit
Ahmed, Nisar
Sharma, Lokesh
Mathur, Rajeev
Tomar, Vinay
author_facet Roy, Siddhant
Bhat, Mahakshit
Ahmed, Nisar
Sharma, Lokesh
Mathur, Rajeev
Tomar, Vinay
author_sort Roy, Siddhant
collection PubMed
description Background Arteriovenous fistulas (AVFs) are considered the first and best access for patients with end-stage renal disease who need permanent vascular access for hemodialysis over arteriovenous grafts and central venous catheters for reasons that have been well-established. Poor early patency rates pose the biggest challenge in creating vascular access as they cause increased morbidity and economic/psychological concerns among patients. To minimize such effects, it is critical to use a patient-centered approach and carefully choose patients for AVF access creation. This study aimed to compare the primary patency of distal vascular access provided by continuous suturing versus that provided by interrupted suturing. Methodology This prospective study was conducted in the urology department of a superspecialty, tertiary care center from November 2021 to November 2022. Patency was assessed immediately after surgery (on the table), one month later, and six months later by palpating thrill and auscultating bruit. A total of 50 patients between the ages of 18 and 70 years who met the inclusion criteria were randomly assigned to two groups of 25 each. Results The baseline characteristics of both groups were comparable. At six months (p = 0.09), the continuous suturing group was observed to be somewhat better than the interrupted suturing group, with no significant difference in immediate and one-month patency rates. When compared to the continuous suturing group, the primary patency failure rate was significantly higher in the interrupted suturing group. Conclusions Thus, under appropriate circumstances, continuous sutures can be performed with greater ease, resulting in anastomosis that is as patent as that performed with interrupted sutures.
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spelling pubmed-104281832023-08-17 A Comparative Study of Continuous Versus Interrupted Suturing Technique in Creating a Vascular Access for Hemodialysis: An Institutional-Based Experience Roy, Siddhant Bhat, Mahakshit Ahmed, Nisar Sharma, Lokesh Mathur, Rajeev Tomar, Vinay Cureus Urology Background Arteriovenous fistulas (AVFs) are considered the first and best access for patients with end-stage renal disease who need permanent vascular access for hemodialysis over arteriovenous grafts and central venous catheters for reasons that have been well-established. Poor early patency rates pose the biggest challenge in creating vascular access as they cause increased morbidity and economic/psychological concerns among patients. To minimize such effects, it is critical to use a patient-centered approach and carefully choose patients for AVF access creation. This study aimed to compare the primary patency of distal vascular access provided by continuous suturing versus that provided by interrupted suturing. Methodology This prospective study was conducted in the urology department of a superspecialty, tertiary care center from November 2021 to November 2022. Patency was assessed immediately after surgery (on the table), one month later, and six months later by palpating thrill and auscultating bruit. A total of 50 patients between the ages of 18 and 70 years who met the inclusion criteria were randomly assigned to two groups of 25 each. Results The baseline characteristics of both groups were comparable. At six months (p = 0.09), the continuous suturing group was observed to be somewhat better than the interrupted suturing group, with no significant difference in immediate and one-month patency rates. When compared to the continuous suturing group, the primary patency failure rate was significantly higher in the interrupted suturing group. Conclusions Thus, under appropriate circumstances, continuous sutures can be performed with greater ease, resulting in anastomosis that is as patent as that performed with interrupted sutures. Cureus 2023-07-17 /pmc/articles/PMC10428183/ /pubmed/37593256 http://dx.doi.org/10.7759/cureus.42004 Text en Copyright © 2023, Roy et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Urology
Roy, Siddhant
Bhat, Mahakshit
Ahmed, Nisar
Sharma, Lokesh
Mathur, Rajeev
Tomar, Vinay
A Comparative Study of Continuous Versus Interrupted Suturing Technique in Creating a Vascular Access for Hemodialysis: An Institutional-Based Experience
title A Comparative Study of Continuous Versus Interrupted Suturing Technique in Creating a Vascular Access for Hemodialysis: An Institutional-Based Experience
title_full A Comparative Study of Continuous Versus Interrupted Suturing Technique in Creating a Vascular Access for Hemodialysis: An Institutional-Based Experience
title_fullStr A Comparative Study of Continuous Versus Interrupted Suturing Technique in Creating a Vascular Access for Hemodialysis: An Institutional-Based Experience
title_full_unstemmed A Comparative Study of Continuous Versus Interrupted Suturing Technique in Creating a Vascular Access for Hemodialysis: An Institutional-Based Experience
title_short A Comparative Study of Continuous Versus Interrupted Suturing Technique in Creating a Vascular Access for Hemodialysis: An Institutional-Based Experience
title_sort comparative study of continuous versus interrupted suturing technique in creating a vascular access for hemodialysis: an institutional-based experience
topic Urology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10428183/
https://www.ncbi.nlm.nih.gov/pubmed/37593256
http://dx.doi.org/10.7759/cureus.42004
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