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The effect of surgeon’s fatigue on early term patency and complications of arteriovenous fistulas: a prospective cohort study

Hakan Yabanoglu, Cagla Bali, Tevfik Avci, İlker Murat Arer, Sedat Yildirim.




Abstract
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Aim: Examining the effect of surgeon’s fatigue on early term patency and complications of arteriovenous fistula (AVF).
Material and Methods: AVFs created for hemodialysis in patients with end-stage renal failure were included in the study. The patients were divided into 2 groups as those operated in the first operation of that day (Group 1) and those operated after the first or second operations (Group 2). The patients were compared with respect to clinical, demographics, postoperative, surgical variables, and operation duration.
Results: A total of 100 patients underwent AVF operation. No statistically significant differences were found between the groups with respect to clinical, demographic, surgical, and postoperative variables. Efficiency of dialysis was found to be higher and complication rate lower in Group 1. But no statistical significance was obtained in terms of early dialysis efficiency and complication rates in between the groups (p>0.05). Complication rate was higher in Group 2 when compared according to operation time as 120, 120-240, and 240< minutes. But no statistical significance was obtained in this manner (p>0.05).
Conclusions: Conclusions: Although not statistically significant, surgical fatigue factor and long operation time increase the rate of early complications and reduce early dialysis efficiency. We think that early term patency of AVF can also be affected by the complication rate. The effect of this variable can be statistically significant with studies having larger sample size.

Key words: Arteriovenous Fistula; Operation Duration; Complication; Surgeon’s Fatigue; Hemodialysis Access.






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