Can Native Arteriovenous Fistula Be Safely Made by Trainees? Comparison of Results of Native Arteriovenous Fistula for Vascular Access Made by Trainees with that by Consultant

Native arteriovenous fistula (AVF) is the preferred mode of vascular access for hemodialysis. Few studies suggest that the results of AVF are influenced by the experience of the operating surgeons. The present study compares the results of the AVF surgery performed by the surgical trainees with consultant. The retrospective data of the patient operated during the period of January to December 2016 was evaluated. The primary success rate and functional status of the AVF at 1 year were compared in the AVFs created by consultant and trainees. A total of 111 patients who underwent AVF were included in the study. Out of these, 47 (41%) were forearm fistulas (radiocephalic) and 64 (59%) were upper arm fistulas. Out of the total, 57 were operated by consultant and 54 were operated by trainees. The distribution of age, gender, diabetes, and type of fistulas was similar in the two groups. The primary success was established in 91 AVF (81.9%). The failure to use the fistula for the dialysis made by trainee was 10/54 (18.5%) and 10/57 (17.5%) by consultant. There was no statistical difference in the result of AVF made by trainees and consultants (p = 0.89, chi-square test). AVFs can be safely made by resident surgeons as a part of clinical training program. This approach may be evaluated in other centers, which could train resident surgeons in general surgery in microvascular surgery and thereby reducing the waiting period for AVF creation.