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Liposuction used to treat deep vascular accesses for hemodialysis.

吸脂术用于治疗血液透析的深部血管通路。

  • 影响因子:1.12
  • DOI:10.1177/1129729820927914
  • 作者列表:"Florescu MC","Plumb TJ","Westphal S","Mullane R","Reilly DA
  • 发表时间:2021-01-01
Abstract

BACKGROUND:Oftentimes, obese dialysis patients develop a viable dialysis access but the access is too deep for cannulation and needs a superficialization procedure. METHODS:We present our 14-patient cohort in whom we performed liposuction to superficialize viable but deep vascular accesses. Out of 14 patients, 12 had arteriovenous fistulas and 2 arteriovenous grafts. The primary end points were the ability to superficialize a completely unusable access and to remove the hemodialysis catheter (3patients), or to significantly extend the useful length of a deep access in which only a very short segment was used and to continue to use the access post-surgery without the need to place a dialysis catheter (11 patients). RESULTS:The study goal was met in 13 out of 14 patients. In two of three patients, the catheters were removed and their access usable length was 14 and 13 cm, respectively. The accesses could be used immediately after liposuction in all patients in which this applied-11 patients. The usable access length increased from a mean of 5 to 12.7 cm. The access mean depth decreased from 10.8 mm pre-surgery to 7 mm post-surgery and 5.3 mm 4 weeks after surgery. The mean volume of fat removed was 43.8 cc. We had only one surgical complication: bleeding that was readily controlled with manual pressure. All patients were discharged to home the same day. Postoperative pain was mild. CONCLUSION:Liposuction is effective, safe, and seems to be the least invasive technique of superficialization.

摘要

背景: 肥胖透析患者通常会形成可行的透析通路,但该通路对于插管来说太深,需要一个肤浅的程序。 方法: 我们介绍了我们的14名患者队列,我们在其中进行了脂肪抽吸术,以使可行但深层的血管通路变浅。在14例患者中,12例有动静脉瘘和2例动静脉移植物。主要终点是能够使一个完全不能使用的通路变浅和移除血液透析导管 (3名患者),或显著延长只使用非常短的节段的深层通路的有用长度,并在手术后继续使用通路,而无需放置透析导管11例患者)。 结果: 14例患者中有13例达到了研究目标。在3名患者中的2名患者中,移除了导管,并且它们的通路可用长度分别为14和13  cm。在所有应用该方法的患者中,吸脂后可立即使用该方法。可用通路长度从平均5厘米增加到12.7厘米。通路平均深度从术前的10.8mm降至术后的7mm和术后4周的5.3mm。去除的脂肪的平均体积为43.8 cc cc。我们只有一个手术并发症: 用手动压力容易控制的出血。所有患者于当天出院回家。术后疼痛较轻。 结论: 脂肪抽吸术是一种有效、安全的微创化技术。

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DOI:10.1007/s11033-021-06299-9
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