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Surgical breakthrough published in The Lancet

A PIONEERING trial led by a number of our surgeons and anaesthetists to improve the treatment of dialysis patients has been recognised in the prestigious international journal The Lancet.

The study, carried out over three years and involving about 130 patients, has resulted in a significantly increased rate of success for people undergoing a regional anaesthetic, rather than a general anaesthetic, to allow the insertion of a line to allow dialysis to take place.

The surgical procedure to create a fistula is carried out under either general anaesthetic or only a localised area of the patient’s arm is numbed. For some patients this operation has to be carried out a number of times before being successful.

Using a regional anaesthetic, the patient’s arm is frozen from the shoulder down, delivering a huge benefit in terms of improved vascular access for patients.

Our small team was led by consultant anaesthetist Alan Macfarlane and consultant surgeon Marc Clancy.

Alan said: “These are important results that will deliver huge patient benefits in terms of improved vascular access for dialysis and reduced complications, particularly catheter-associated bacteraemia. I think the study will have a major influence on how fistula surgery is performed worldwide.”

Publication in The Lancet is also a personal accolade for the study author, surgical registrar Dr Emma Aitken, who is based at the Queen Elizabeth University Hospital. It is the first time she has been published in the journal, which only accepts five per cent of submissions it receives.

Emma said: “Journals are ranked by impact factor, which means how many people read it and how difficult it is to have research published, and The Lancet has a very high impact factor.

World leaders in their field will be reading about our work and this makes us feel extremely proud of what we’ve achieved.”

Her study was funded by Darlinda’s Charity for Renal Research and Regional Anaesthesia UK.

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Pictured above: Dialysis patients require surgery to insert a line to allow treatment to take place