A Surgeon’s Perspective on Dialysis Patients

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Maria Frankovicova (Editor) – University Pavol Jozef Safarik, Professor of Surgery; Chief of Department of Vascular Surgery, East Slovak Institute of Cardiovascular Diseases, Medical Faculty of Safarik University, Kosice, Slovakia

Series: Surgery – Procedures, Complications, and Results

BISAC: MED085000

Every year a large number of chronic patients undergo dialysis at dialysis departments in the Slovak Republic. Each one of them is connected to the artificial kidney 100 to 160 times. The most valuable property of these patients is a quality and long-term functioning arteriovenous fistula since it is one of the essential conditions for successful dialysis. The surgeon who creates arteriovenous access must thoroughly examine the patient before the operation, properly evaluate the vascular system and choose the most favorable way of the vascular access for long-term hemodialysis. Patients with chronic renal failure have impaired hemostasis, several of them have diabetes and their vascular system is affected by atherosclerosis. Determination of the operational plan and optimal vascular access is strictly individual and depends not only on the vascular system of the patient but also on the general condition, age and prognosis of the disease. A quality arteriovenous fistula should conform to the requirements of the simplest and the shortest operation as possible, using local anesthesia. Underestimation of any fact can result in the creation of many non-functional AV fistulas. AV fistulas operations for the purpose of long-term hemodialysis are an integral part and one of the most problematic issues of vascular surgery. There are more and more patients who are in the long-term hemodialysis program. The average age of patients is increasing. All these factors have resulted in the need to create more and more AV fistulas because their usability is limited. The correct operational tactics, individual approach to the patient and precise surgical technique of the vascular surgeon contribute to the improvement of the quality of life of sick patients, of whom only a small percentage is so lucky that the disease is cured by successful kidney transplantation.

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Table of Contents

Introduction

Chapter 1. Vascular Access
(M. Frankovičová, MD – Department of Vascular Surgery, East Slovak Institute of Cardiovascular Diseases, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Košice, Slovakia)

Chapter 2. Arteries and Veins of Upper Limbs
(L. Vaško, MD and M.Virág, MD – Department of Vascular Surgery, East Slovak Institute of Cardiovascular Diseases, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Košice, Slovakia)

Chapter 3. Chronic Kidney Disease from the Surgeon’s Perspective
(M. Zavacká, MD – Department of Vascular Surgery, East Slovak Institute of Cardiovascular Diseases, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Slovakia)

Chapter 4. External and Subcutaneous Arteriovenous Connections
(M. Zavacká, MD – Department of Vascular Surgery, East Slovak Institute of Cardiovascular Diseases, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Slovakia)

Chapter 5. Methods and Principles of Forming Arteriovenous Fistulae (Pre-operative Assessment, Patient and Operating Room Preparation, Postoperative Care)
(M. Zavacká, MD – Department of Vascular Surgery, East Slovak Institute of Cardiovascular Diseases, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Slovakia)

Chapter 6. Monitoring of Vascular Accesses, Causes of Vascular Access Failures, and Prevention and Treatment Options
(N. Torma, MD – Angiosurgical Department of the Medical Faculty of Pavol Jozef Safarik University, Košice, Slovakia)

Chapter 7. Complications of Arteriovenous Connection (Arteriovenous Fistulas)
(M. Zavacká, MD – Department of Vascular Surgery, East Slovak Institute of Cardiovascular Diseases, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Slovakia)

Chapter 8. Long-term Central Venous Access – PERMCATH
(J. Pobehová – Department of Vascular Surgery, East Slovak Institute of Cardiovascular Diseases)

Chapter 9. Repeated Formation Of An Arteriovenous Connection
(N. Torma, MD – Angiosurgical Department of the Medical Faculty of Pavol Jozef Safarik University, Košice, Slovakia)

Chapter 10. Peritoneal Dialysis
(P.Zavacký – Department of Surgery, Faculty of Medicine, Pavol Jozef Šafárik University in Košice and University Hospital, Košice, Slovakia)

Chapter 11. Skin Covering in Dialysis Accesses from the Point of View of a Plastic Surgeon
(M. Vidová Uğurba, MD – Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Pavol Jozef Šafárik University in Košice and University Hospital, Košice, Slovakia)

Chapter 12. Kidney Transplantation
(P.  Zavacký – Department of Vascular Surgery, East Slovak Institute of Cardiovascular Diseases)

Chapter 13. Vascular Accesses and Possible Complications from the Cardiology Point of View
(D. Pella, MD – 1st Department of Cardiology VUSCH a.s, Faculty of Medicine, Pavol Jozef Šafárik University in Košice and University Hospital, Košice, Slovakia)

Chapter 14. Case Studies of Patients at the Department of Vascular Surgery
(J. Pobehová – Department of Vascular Surgery, East Slovak Institute of Cardiovascular Diseases)

Chapter 15. Thoracosurgical Complications in Dialysis Patients
(J. Belák, MD – 2nd department of Surgery, Faculty of Medicine, Pavol Jozef Šafárik University in Košice and University Hospital, Košice, Slovakia)

Chapter 16. Skin Diseases Associated with Chronic Renal Failure
(J. Baloghová – Department of Dermatovenerology, Faculty of Medicine, Pavol Jozef Šafárik University in Košice and University Hospital, Košice, Slovakia)

Index

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