title: The effect of the keyhole technique on diabetic patients undergoing autologous brachiobasilic transposition of an arteriovenous fistula.
abstract: OBJECTIVE
  Our aim was to investigate the efficiency of the keyhole transposed brachiobasilic technique in patients with diabetes mellitus and compare the effect of different arteriovenous fistula techniques on the development of complications.
  
  
  METHODS
  Thirty-eight diabetic, chronic renal failure patients (group 1) had transposed brachiobasilic arteriovenous fistula creations, and 49 diabetic patients (group 2) had other types of fistula creations and histories of multiple fistula attempts. The 2 groups were compared for age, sex, weight, the presence of hypertension and/or diabetes mellitus, other risk factors, arteriovenous fistula patency, and possible complications.
  
  
  RESULTS
  The 2 groups were not different statistically regarding the demographic data including age, sex, weight, the presence of hypertension and/or diabetes mellitus, other risk factors, and mean operation time. The median follow-up after surgery in both groups was 8 months. The primary patency in group 1 was 97.4% in the early period (6 weeks after surgery) and 94.7% in the late period (mean duration of 8 months after surgery). In the second group, these rates were 73% and 62%, respectively (P < .05). The secondary patency rates were 84.2% in group 1 and 53% in group 2 (P < .05). In group 2, the primary and secondary patencies of brachiocephalic and radiocephalic fistulas were significantly lower than the patencies of group 1. The incidence of complications was significantly less in group 1 than in group 2 (P < .05).
  
  
  CONCLUSIONS
  Although the groups were small in size, the success rate with the keyhole transposed brachiobasilic technique in patients with diabetes was extremely gratifying, and this report can be considered to document the first attempt of a hemodialysis-access procedure.
authors.affiliation: Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, Istanbul, Turkey.
authors.forename: Ilyas
authors.initials: I
authors.lastname: Kayacioglu
authors.forename: Ayse
authors.initials: A
authors.lastname: Baysal
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ates
authors.forename: Unsal
authors.initials: U
authors.lastname: Vural
authors.forename: Ahmet Yavuz
authors.initials: AY
authors.lastname: Balci
authors.forename: Huseyin
authors.initials: H
authors.lastname: Saskin
authors.forename: Abdullah
authors.initials: A
authors.lastname: Celik
authors.forename: Rahime Pinar
authors.initials: RP
authors.lastname: Alkan
authors.forename: Atilla
authors.initials: A
authors.lastname: Kanca
mesh_terms: D000328:Adult; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D001367:Axillary Vein / Q000601:surgery*; D001916:Brachial Artery / Q000601:surgery*; D002408:Catheters, Indwelling; D003928:Diabetic Nephropathies / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D014182:Transplantation, Autologous; D014654:Vascular Patency / Q000502:physiology