Egyptian Journal of Surgery最新文献

{"title":"Outcomes of laparoscopic SG and laparoscopic one-anastomosis gastric bypass in terms of improvement in the lipid profile","authors":"Eman Mahmoud, Mohamed A. Baky Fahmy, Ehab Fathy, Mohamed Elshal, Ahmed Maher Elmonim","doi":"10.4103/ejs.ejs_56_23","DOIUrl":"https://doi.org/10.4103/ejs.ejs_56_23","url":null,"abstract":"Introduction Obesity is associated with an increased mortality rate, particularly of cardiovascular origin, due to the close association between obesity and cardiovascular risk factors such as dyslipidemia. The efficacy of different bariatric Surgeries in weight reduction and in glycemic homeostasis improvement has been widely described. In contrast, little is known about the effects of bariatric surgery on lipid profile. Few studies have compared the effect of different surgical techniques on lipid profile changes. So, we aim at assessing and comparing the effect of SG and OAGB in terms of improvement in the lipid profile. Patients and methods This is a prospective comparative study that included 46 morbidly obese patients. Patients were divided into two groups: SG group (23 patients), and OAGB group (23 patients). Preoperative and 3 months post-operative cholesterol levels, triglycerides, LDL (Low-density lipoprotein), and HDL (High-density lipoprotein) were measured. The results were documented, analyzed, and correlated to baseline results, and results from the two groups were compared together. Results This study revealed that most of our patients who were candidates for bariatric surgeries either SG or OAGB presented with elevated mean LDL, Cholesterol, and triglyceride and decreased mean HDL. The results showed a significant improvement of lipid profile after both SG and OAGB over a 3-month interval. There was a statistically significant difference between the two operations in the decrease of cholesterol over 3 months postoperatively in favour of the OAGB operation; hence the significant difference is observed in the change of the cardiovascular risk and improvement of quality of life of those patients underwent OAGB. Conclusion Obese patients have shown an association with elevated LDL, Cholesterol, and triglyceride and decreased HDL. SG and OAGB both result in a significant decrease in LDL, Cholesterol and triglyceride and an increase in HDL.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"42 1","pages":"378 - 384"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43971503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of concomitant vascular injury on the outcome of bile duct injury","authors":"A. Sallam, I. Marwan, Motasem M. Ali, A. Gamal, Saleh Khairy, I. Ayoub, A. Attia, Ghadier Saaed, O. Hegazy","doi":"10.4103/ejs.ejs_64_23","DOIUrl":"https://doi.org/10.4103/ejs.ejs_64_23","url":null,"abstract":"Background Compared with open cholecystectomy, the frequency of iatrogenic bile duct damage (bile duct injury) has almost doubled as laparoscopic cholecystectomy (LC) has become more prevalent. The authors aimed to analyze the prevalence of postcholecystectomy vasculobiliary injury and its influence on illness and death. Methods Medical records were reviewed on 50 consecutive patients with iatrogenic bile duct injuries from either open or laparoscopic cholecystectomy who were treated at the National Liver Institute, Menoufia University between January 1, 2020 and October 31, 2022. The medical records were examined for patient demographics and preoperative and postoperative clinical scenarios, which included symptoms, operative procedures, diagnostic methods, operative repairs, length of ICU and Hospital stays, postoperative follow-up, short- and long-term complications, need for radiographic or operative revision, and patient mortality. Results The studied patients were allocated into two groups, according to presence of concomitant vascular injury; group A: cases did not develop concomitant vascular injury, group B: cases developed concomitant vascular injury. Vascular injury was significantly elevated in males than those without vascular injury (P=0.027). There were no significant variance among the studied groups as regard Hospital stay and ICU admission. There was no significant variance among the studied groups as regard short-term complications. There was a significant variance among the studied groups as regard long-term complications (P=0.003). Right lobe atrophy was significantly elevated in vascular injury cases than those without vascular injury. Conclusions Concomitant vascular injury postcholecystectomy prevalence was significantly associated with long-term complications; right lobe atrophy was significantly elevated in vascular injury cases than those without vascular injury.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"42 1","pages":"502 - 508"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47372013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain and quality of life after laparoscopic unilateral inguinal hernia repair","authors":"A. Azam, Waleed Borham, A. Abbas, Magdy Basheer","doi":"10.4103/ejs.ejs_77_23","DOIUrl":"https://doi.org/10.4103/ejs.ejs_77_23","url":null,"abstract":"Introduction Surgical repair of inguinal hernias is one of the most frequently performed operations. Transabdominal preperitoneal (TAPP) and Total extraperitoneal (TEP) methods are the two commonly employed laparoscopic methods for herniorrhaphy. Objective To evaluate the pain and quality of life (QoL) following laparoscopic inguinal hernia surgery utilizing the TAPP and TEP methods. Patients and methods One hundred individuals with unilateral inguinal hernias who had received a clinical diagnosis participated in this prospective trial. The research population was randomly split into two groups by computer-generated software: group A, which consisted of 50 inguinal hernia patients who experienced laparoscopic TAPP surgery, and group B, which consisted of 50 inguinal hernia patients who were treated with laparoscopic TEP surgery. Results After one week and one month postoperatively, the TAPP group had a higher median pain VAS score than the TEP group, which was significant statistically (p values 0.001 and 0.001, respectively). The two groups’ VAS scores did not differ significantly after three- and six-months follow-up. In terms of preoperative and six-month postoperative QoL related domains, the TAPP versus TEP patients showed insignificant difference. Cases involving TAPP and TEP showed an increase of statistical significance in QoL domains from preoperative to six months following surgery. Conclusion According to our investigation, TEP is superior to TAPP. When performed by skilled hands, it appears to be the best method for repairing inguinal hernias.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"42 1","pages":"418 - 424"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43903532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatico-jejunostomy versus pancreatico-gasrostomy after pancreatico-duodenectomy in decreasing postoperative pancreatic fistula","authors":"Sayed Shaker Shaeir, M. A. ElKordy, M. E. Sobeih, R. Allam, Ayman Hanafy","doi":"10.4103/ejs.ejs_91_23","DOIUrl":"https://doi.org/10.4103/ejs.ejs_91_23","url":null,"abstract":"Background Pancreatico-duodenectomy is still the cornerstone in curating pancreatic and periampullary cancers. Many techniques for pancreatic anastomosis were described. Pancreatico-gastrostomy (PG) may be a suitable technique, especially in small pancreatic ducts where the stitching of duct to mucosa may be difficult. Still, the results of pancreatico-gastrostomy compared to pancreatico-jejunostomy (PJ) in terms of morbidity are not well studied; hence, this study was designed to investigate. Objective To compare pancreatico-gastrostomy versus pancreatico-jejunostomy post pancreatico-duodenectomy from points of operative techniques and characteristics, and postoperative morbidity and mortality. Patients and methods The Cohort study included all cases diagnosed with either pancreatic head or periampullary cancers and underwent pancreatico-duodenectomy at National Cancer Institute (NCI), Cairo University, between January 2021 and February 2023. Cases were enrolled into one of the two groups, group 1: underwent pancreatico-gastrostomy, while group 2 underwent pancreatico-jejunostomy. The two groups were compared by: Demographic characteristics, preoperative investigations results, operative, postoperative data and histopathological results of the specimens resected. Results Incidence of the pancreatic leak was not significantly different in both groups (17.6% versus 15.8% for PG and PJ respectively, P=0.833), operative time was shorter in a pancreatico-gastrostomy group (310, 355 min, P=0.001), Delayed gastric emptying (DGE) was less occurred in cases of pancreatico-gastrostomy (5.9%, 31.6%, P=0.006). Postoperative mortality was not different in both groups (8.8%, 2.6% for PG and PJ respectively, P=0.338). Conclusion Regarding the incidence of postoperative pancreatic fistula, both reconstruction methods produce comparable postoperative results. Pancreatico-gastrostomy is a good alternative technique to the standard pancreatico-jejunostomy.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"42 1","pages":"473 - 481"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42371420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of donut mastopexy as a conservative breast surgery in juxta areolar early breast cancer","authors":"Mahmoud A. Abdallah, Ashraf A. Mostafa, A. Osman, B. Ayoub","doi":"10.4103/ejs.ejs_78_23","DOIUrl":"https://doi.org/10.4103/ejs.ejs_78_23","url":null,"abstract":"Background In order to give a treatment as effective as mastectomy with the added benefit of a preserved breast, breast conserving surgery has evolved into the accepted course of action for the diagnosis and treatment of breast cancer. Donut mastopexy is one of the cancer breast surgery techniques that is used. Objective Evaluation of donut mastopexy as a conservative breast surgery in juxta areolar breast cancer. Methods A total of 50 female patients with early breast cancer near nipple-areolar complex were enrolled. Cosmetic outcome was evaluated during the early postoperative period and on follow-up. Operative time, intra and postoperative bleeding, drain content, wound complication as seroma or surgical site infection, symmetry, patient and doctor satisfaction were evaluated. Results Breast imaging reporting and data system (BI-RADS) classification of the obtained specimens of the study population showed that 12 (24%) had grade 4 and 38 (76%) had grade 5. Preoperative tru-cut biopsies of the obtained specimens of the study showed that 34 women (68%) had infiltrative ductal carcinoma, 10 women (20%) had ductal carcinoma in situ, four women (8%) had infiltrative lobular carcinoma and two women (4%) had mucinous carcinoma. Preoperative true-cut biopsies of the obtained specimens showed that 34 patients (68%) had infiltrative ductal carcinoma, 10 patients (20%) had ductal carcinoma in situ, four patients (8%) had infiltrative lobular carcinoma and two patients (4%) had mucinous carcinoma in-situ component of the obtained specimens showed that 13 patients (26%) had no in-situ component, 16 patients (32%) had less than or equal to 5% and 21 patients (42%) had greater than 5-25% intraoperative bleeding were three patients (6%); mean of drain content (volume) was 26.29±2.79 and mean of operative time (min) was 93.16±13.62. The most common complication was seroma (10%) and four patients (8%) were bleeding; followed by hematoma and delayed wound healing, and there was agreement on the ratio (6%) and infection and axillary wound seroma, and there was agreement on the ratio (4%), on the other hand partial nipple/skin necrosis and wound dehiscence was the lowest noticed complication, and there was agreement on the ratio (2%); as for the surgical site infection was five patients (10%) were hotness, four patients (8%) were redness and three patients (6%) were swelling. The patient satisfaction was 33 patients (66%) were excellent of satisfaction, nine patients (18%) were very good of satisfaction, seven patients (14%) were good satisfaction, and one case (2%) was poor satisfaction. Additionally, there was 31 doctors (62%) were excellent of satisfaction, 11 doctors (22%) were very good of satisfaction, 8 doctors (16%) were good satisfaction, while there is no poor cases among doctor satisfaction. Conclusion Donut mammography results in good cosmetic results. The study’s overall cosmetic outcome was more gratifying, and this was evident in the patients’ psych","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"42 1","pages":"516 - 525"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44270480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided quadratus lumborum block versus transversus abdominis plane block in postoperative pain management after laparoscopic sleeve gastrectomy","authors":"R. Hussien, A. M. Elsaid, Mohamed Y. Abd Elraziq, R. Mahrose","doi":"10.4103/ejs.ejs_83_23","DOIUrl":"https://doi.org/10.4103/ejs.ejs_83_23","url":null,"abstract":"Background Patients undergoing abdominal surgeries may benefit from an ultrasound-guided quadratus lumborum block (QLB) as one of the postoperative pain management techniques. Objective This study compares the effects of bilateral ultrasound guided Transversus abdominis plane (TAP) block versus bilateral ultrasound guided QLB on postoperative analgesia in patients having laparoscopic sleeve gastrectomy (LSG) under general anaesthesia (GA). Patients and methods 45 patients who were scheduled for elective LSG participated in a randomized controlled trial. All patients were given 1–2 μg/kg of intravenous fentanyl as intraoperative narcotic during GA. QLB Group (15 patients): received ultrasound-guided QLB using 0.2 mL/kg of 0.25% bupivacaine per side after induction of general anaesthesia. TAP Group (15 patients): received ultrasound-guided TAP block using 0.2 mL/kg of 0.25% bupivacaine per side after induction of general anaesthesia. Control Group (15 patients): received general anaesthesia and then 1 gm IV paracetamol and 30 mg IV ketorolac within first hour and 8 h postoperative. Results QLB group used pethidine as rescue analgesia mush less than other groups with highly statistically significant difference (P value<0.001). Also, there was statistically significant difference between groups in number of patients needed rescue analgesia (60% of QLB group, 86.7% of TAP group and 100% of control group). Also, the QLB group had superior clinical pain scores than the other groups with a statistically significant difference at PACU arrival, 30 min, 2 h, and 4 h postoperative. The TAP group had a lower VAS score than the control group, with a statistically significant difference at PACU arrival and 4 h postoperative. In comparison to the TAP group, the VAS score was lower in the QLB group, with a statistically significant difference at 30 min postoperatively. MAP was significantly lower in the QLB group than in the control group at PACU entry, 30 min, and 6 h postoperatively. However, MAP was lower in the QLB group than in the TAP group, with a statistically significant difference only at the 12- and 24-hour post-operative time points. HR was less significantly in QLB group than control group at 30, 2, 12, 24 h postoperatively, when comparing the HR between the QLB and TAP groups, the difference became statistically significant only at the 12-hour post-operative time. Conclusion In compared to TAP block and IV analgesics, QLB was the most efficient method for delivering analgesia following LSG.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"42 1","pages":"526 - 534"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41974670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Our experience with pancreatic injury due to trauma in a rural area","authors":"I. Taş, Ebral Yiğit, H. Bilge","doi":"10.4103/ejs.ejs_96_23","DOIUrl":"https://doi.org/10.4103/ejs.ejs_96_23","url":null,"abstract":"Aim We aimed to analyze The pancreatic injuries due to trauma and their treatment. Material and methods This study includes the data of ten patients who were operated on due to abdominal trauma and were further diagnosed with pancreatic trauma in the General Surgery Service between January 2016 and December 2019. Results Of the 472 patients admitted to our hospital with abdominal trauma, 10 had pancreatic injuries. Seven (70%) of these patients were male and three (30%) were female. When the causes of the injuries were examined, six (60%) had gunshot wounds (GSW), three (30%) had stab wounds (SW), and one (10%) had a pancreatic injury due to falling from a height. Abdominal computed tomography (CT) scans were performed in eight (80%) patients. One patient’s CT was reported as normal. Other scans indicated findings suggestive of abdominal injury, such as free air and free fluid in the abdomen. Following the pancreas, the stomach was the most injured organ (80%), followed by the liver, spleen and kidney, respectively. An isolated pancreatic injury was observed in only one case. Complications developed in eight (80%) patients, Three (30%) of our patients died in the postoperative period. The mean hospital stay of the patients was 9.8±6.14 (min: 3, max: 24) days. Conclusion The pancreas is not commonly injured in abdominal trauma.. Even if preoperative imaging methods are normal, the pancreas should be explored in order not to miss pancreatic injuries in trauma patients who were operated on.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"42 1","pages":"497 - 501"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46489822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of biological markers in loco-regional recurrence of breast cancer after mastectomy and radiotherapy","authors":"M. Mahmoud, T. Ouf, T. Kamal, Heba Tharwat El Aziz","doi":"10.4103/ejs.ejs_82_23","DOIUrl":"https://doi.org/10.4103/ejs.ejs_82_23","url":null,"abstract":"Objective To assess the prognostic usefulness of the human epidermal growth factor receptor-2 (Her 2), the progestin receptor (PR), and the oestrogen receptor (ER) in locoregional recurrence following mastectomy radiotherapy in Egyptian breast cancer patients. Patients and methods This retrospective analysis comprised 432 female patients who had received radiation and had a mastectomy and immunohistochemistry reports. The Ethics Committee’s clearance was required before this study could be carried out at the Ain-Shams University hospitals. Results A total of 24 individuals developed LRR after a median follow-up period of 68.9 months. Although lymph nodes with more than three exhibited a statistically significant risk for LLR, tumour grade and pT were not significant risk factors. LRR risk rose for those who were HER2-positive and those with TNBC, but Luminal B had a non-significantly greater risk than Luminal A. Conclusion For breast cancer patients receiving PMRT, the biological subtype based on the categorization standard from the St. Gallen International Breast Cancer Conference (2013) Expert Panel acts as an accurate prognostic predictor. In HER2-positive and hormonal receptor-positive individuals, trastuzumab treatment significantly reduced the risk of LRR.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"42 1","pages":"439 - 443"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44623967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study between anterior and posterior approach in emergent femoral hernia","authors":"Mahmoud Alabassy, Alaa A. Elsisy, S. Alhanafy","doi":"10.4103/ejs.ejs_80_23","DOIUrl":"https://doi.org/10.4103/ejs.ejs_80_23","url":null,"abstract":"Objectives/aims Emergency surgery is necessary for incarcerated and/or strangulated femoral hernias. With regard to emergency femoral hernia repair, this study attempted to compare between open anterior and open posterior (preperitoneal) techniques. Methods Patients who underwent emergency femoral hernia repair between October 2020 and October 2022 were included in this single centre retrospective cohort research. They were divided into two groups based on the surgical incisions: the anterior approach group (19 cases) and the posterior approach group (14 cases). Open anterior and posterior methods were compared using patient demographic information, intraoperative findings, operating time, and postoperative outcomes. Results 33 patients in total were included in the current study. 19 patients (57.6%) underwent open anterior approach, whereas 14 patients (42.4%) underwent open preperitoneal approach. Patient features indicated a similarity between the two groups. The posterior approach group experienced considerably shorter mean operative time (53.624 7 min vs 77.936 5 min, P = 0.039) and recovery time (9.24 1days vs 13.36 6days, P = 0.049) before returning to full activity. The posterior approach group had a decreased (7.14%) rate of postoperative complications, such as wound infection, seroma/hematomas, persistent discomfort, and hernia recurrence. Conclusion While it can increase the rate of first-stage tension-free repair of incarcerated femoral hernia and with a lower risk of postoperative complications, the open preperitoneal approach for emergency femoral hernia may be preferable to other procedures.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"42 1","pages":"425 - 432"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41906994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of immediate postoperative increase in blood flow velocity in predicting maturation of arteriovenous fistula for dialysis","authors":"Mohamed Meaad, A. Mashaal, M. Zaki","doi":"10.4103/ejs.ejs_72_23","DOIUrl":"https://doi.org/10.4103/ejs.ejs_72_23","url":null,"abstract":"Background Doppler ultrasonography is the main imaging modality for hemodialysis arteriovenous fistula (AVF) as it is safe, accurate, and noninvasive. Published literature related to the utility of early postoperative ultrasound in predicting AVF maturation is scarce. With the KDOQI guidelines recommending an AVF first catheter last approach, the quest to increase AVF maturation is of utmost importance. This study aims at measuring blood flow immediately postoperatively and assessing its predictive role in AVF maturation. Methods We correlated the ultrasound parameters with maturation in newly created AVFs measured preoperatively, immediately postoperatively, 6 weeks, and 3, 6, and12 months postoperatively. Both demographics and vascular parameters were compared between the group of patients whose AVFs successfully maturated and those whose AVFs did not. Primary endpoint was AVF maturation; secondary endpoints included patency, functional success, and predictive value of increased vein blood flow on fistula patency. Results A total of 50 procedures were performed; the mean age was 52.12 years (±6.58). The overall technical success rate was 86% (43) and 39 (90.7%) of them were functionally mature according to KDOQI guidelines for maturation. Primary patency was 93.02%, 92.7%, and 88.89%; and the primary-assisted patency was 97.7%, 95.12%, and 91.67% at 3, 6, and 12 months, respectively. Receiver-operated curve (ROC) showed a cutoff value of 322.8 ml/min increase in blood flow above which the AVF is more likely to become mature. Binary logistic regression showed that arterial depth greater than 3.92 mm, arterial flow velocity greater than 88 ml/min, preoperative average vein diameter of greater than 2.5 mm, arterial flow velocity of greater than 73 ml/min immediately postoperatively, and average vein diameter of greater than 3.94 mm immediately postoperatively were significant predictors of successful maturation at 6 weeks postoperatively (P values 0.001, <0.0001, <0.0001, <0.0001, and <0.0001, respectively). Conclusion Immediately postoperative flow measurement is a reliable parameter that can be used to predict successful fistula maturation, especially if flow velocities exceed 326.15 ml/min.","PeriodicalId":43393,"journal":{"name":"Egyptian Journal of Surgery","volume":"42 1","pages":"559 - 572"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41564879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}