title: What is the best training for vascular access surgery?
abstract: Questions have been raised whether there is a lack of appropriate training in access creation and maintenance, and if training juniors in arteriovenous (AV) fistulas may affect the outcome. A survey was undertaken to study "experts" opinion in access training using a closed questionnaire. The majority of "experts" consented that there is a lack of appropriate training in access creation and maintenance in a great extent, although they located the main deficit regarding access training in the preoperative planning and decision making. Regarding the second question, a literature search revealed only four studies, comparing the outcomes of AV fistulas created either by consultant surgeons or trainees. A meta-analysis performed revealed that 1-year patency rate was not statistically significant different among access procedures created either by consultants or trainees. Access surgery shares the same basic principles with vascular surgery and provides a valuable workload for the trainees and is a necessity to become a building component in all "core" vascular curricula; the required skills can be acquired with the trainees operating independently simple cases, as the latter is not leading to suboptimal outcomes.
authors: Department of Vascular Surgery, Democritus University Hospital, Alexandroupolis - Greece.
authors: Miltos K
authors: MK
authors: Lazarides
authors: George S
authors: GS
authors: Georgiadis
authors: Efstratios I
authors: EI
authors: Georgakarakos
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000193:education*; D016009:Chi-Square Distribution; D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology; D019538:Health Care Surveys; D006801:Humans; D007396:Internship and Residency; D016017:Odds Ratio; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000628:therapy*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency