1. A meta-analysis of traditional and functional end-to-side anastomosis in radiocephalic fistula for dialysis access
- Author
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Jiang Huaqin, Gong Lifeng, Li Yani, Xu Wei, Tang Weigang, Li Hui, and Lu Jingkui
- Subjects
Nephrology ,medicine.medical_specialty ,Dialysis access ,Urology ,Arteriovenous fistula ,030204 cardiovascular system & hematology ,Anastomosis ,Cochrane Library ,law.invention ,Nephrology - Review ,03 medical and health sciences ,Arteriovenous Shunt, Surgical ,0302 clinical medicine ,Randomized controlled trial ,Renal Dialysis ,law ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Functional end-to-side anastomosis ,Vein ,business.industry ,medicine.disease ,Surgery ,Meta-analysis ,medicine.anatomical_structure ,Radial Artery ,business ,Cohort study - Abstract
Objective Functional vein end to arterial side (ETS) anastomosis uses vein side to arterial side (STS) anastomosis with distal vein ligation, which can achieve similar effects as those of ETS after STS anastomosis. The purpose of the study was to provide a meta-analysis to compare the clinical outcomes between traditional and functional ETS anastomosis in radiocephalic fistula for dialysis access. Methods Databases including PubMed, EMbase, the Cochrane Library, CNKI, Wanfang database were searched from the inception to February 6, 2020. Eligible studies comparing traditional and functional ETS anastomosis in radiocephalic fistula were included. Data were analyzed using Review Manager Version 5.3. Results Seven studies were included in the meta-analysis. Five randomized controlled trials and two cohort studies involving 841 patients were identified. Compared with traditional ETS anastomosis, functional ETS anastomosis had shorter anastomosis time (MD − 9.54, 95% CI − 17.96 to − 1.12, P = 0.03), higher surgical success rate (OR 3.80, 95% CI 1.76–8.22, P P P = 0.03), higher patency rate after 6 months (OR 1.90, 95%CI 1.09–3.31, P = 0.02), higher patency rate after 12 months (OR 1.70, 95% CI 1.09–2.66, P = 0.02). There was no difference after the two arteriovenous (AVF) anastomosisl methods concerning AVF maturation time (SMD − 0.48, 95% CI − 1.30–0.34, P = 0.25) and patency rate after 1 month (OR 1.77, 95% CI 0.65–4.80, P = 0.26). Conclusion Functional ETS anastomosis had advantages of easy operation, high surgical success rate, few complications, high patency rate of 3 months and long-term, but did not have obvious advantage in the early stages concerning AVF maturation time and 1-month patency rate.
- Published
- 2021