WHAT IS FISTULA SURGERY?
DIALYSIS FISTULA
It is the operation of combining the superficial artery and vein in order to enter dialysis in Chronic Renal Failure (CRF).
– Also called arteriovenous fistula (AVF) surgery.
-Technically, the connection is made side by side (parallel) or end by side. The end side is more preferred.
– The fistula formed has a high velocity due to the difference in flow between the artery and the vein.
– As a result of the fistula, the blood coming from the artery expands the vein over time.
– By inserting a needle into the enlarged vein, the blood is taken to the dialysis machine, cleaned and given back.
– The fistula is most often in the arm, but may also be in the leg or elsewhere on the shoulder or neck.
– A catheter is inserted when dialysis is required for a short time. Some of these catheters are temporary and some are permanent.
– Fistula provides PERMANENT AND CONTINUOUS dialysis.
FISTULA IN SNOW AREA
– The Nephrologist decides when to open the fistula?
– The maturation of the fistula may take 2-3 weeks, depending on the vessel diameter.
– For fistula, in principle, the vessels should be evaluated with Doppler ultrasonography.
– It is difficult to open a fistula in the veins below this area in patients who have used or placed a catheter from the shoulder. Even if it is opened, the chance of working is low.
– The main element for the functioning of the fistula is the use of the patient’s own veins. The most important is their diameter.
– The operation is performed with local anesthesia.
– The unused non-dominant arm is selected.
FISTULA IN SNOW AREA
– Start from the end, if unsuccessful, go up. The most suitable is the Snuff Box Snuff Zone. Then the wrist and elbow area is used.
– Unfortunately, in patients who do not have enough vessels or who have many fistulas and do not work, fistulas must be made with artificial veins. Since these grafts are used frequently, they cause distress to patients due to both infection and clot problems.
-The current technique is the fistula made using the patient’s own vessels.
– Sometimes the vein becomes very enlarged and changes due to venous hypertension are observed. In this case, the fistula can be closed due to the development of a clot and the decrease in the flow of the artery.
– Unfortunately, in patients who do not have enough vessels or who have many fistulas and do not work, fistulas must be made with artificial veins. Since these grafts are used frequently, they cause distress to patients due to both infection and clot problems.
– The possibility of infection and blockage is high. The artificial vein of the graft is difficult to maintain.
– It gives better results to the use of the patient’s own veins.
– When the fistula starts to work, a buzzing or ringing can be felt when you put your finger on it, this is an indication that the fistula is working.
– It is important to care for the fistula after the operation. In our country, dialysis centers guide patients in this regard.
· Check whether the fistula is working, do not carry heavy objects, do not sleep on it, do not have the blood pressure measured on the side with the fistula.
Sometimes, when the fistula is very developed, it can cause pain and discoloration, especially in the lower part. For this reason, fistulas that move upwards and unilaterally, not bilaterally, are generally opened today. The veins can sometimes become very dilated. In this case, if blood thinners are not used or due to low flow, there may be a clot in the fistula.
In this case, the flow decreases and the dialysis machine does not work effectively, as a result, the clot in the fistula needs to be cleaned.
Doppler ultrasound examination is sufficient for fistula. It can be demonstrated by angiography. Contrast (dye) material is used in angiography. The dye is also excreted by the kidneys. Sometimes this substance can predispose patients to heart failure and pulmonary edema. You need to pay attention. May need hemodialysis.
Key
What is fistula surgery, fistula
Dialysis, serdar akgun
