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Vascular access surgery as an outpatient procedure
S E Wilson1, T P Connall, R White
1Department of Surgery, University of California, Irvine Medical Center, Orange 92668.
Annals of Vascular Surgery
|July 1, 1993
Summary
Outpatient vascular access surgery in an ambulatory center is safe and effective for hemodialysis patients. This approach reduces hospitalizations and infections, offering a viable alternative to traditional inpatient procedures.
Area of Science:
- Vascular Surgery
- Nephrology
- Ambulatory Surgery
Background:
- Vascular access construction for hemodialysis traditionally occurs inpatient or with 1-day hospital admission.
- Ambulatory surgical centers offer a potential alternative for these procedures.
Purpose of the Study:
- To evaluate the safety and efficacy of performing vascular access procedures for hemodialysis in a freestanding ambulatory surgical center.
Main Methods:
- 49 vascular access procedures were performed on 45 patients over 18 months in an ambulatory surgical center.
- Procedures included arteriovenous fistula construction, polytetrafluoroethylene (PTFE) bridge graft insertion, graft reconstruction, and thrombectomy.
- A strict protocol including preoperative evaluation, anesthesia, and post-procedure observation was followed.
Main Results:
- Only one patient (84-year-old female) required hospitalization post-procedure due to inability to self-care.
- No postoperative infections were reported at 1-month follow-up.
- One previously placed graft at an inpatient facility was removed due to infection, highlighting potential benefits of the ambulatory approach.
Conclusions:
- Vascular access surgery for hemodialysis can be safely and effectively performed in an ambulatory surgical center.
- This outpatient model demonstrates low complication rates and offers a practical alternative to inpatient settings.
- The established protocol supports successful outcomes in ambulatory vascular access surgery.