Abstract: 【Abstract】Objective To search for the best ligature technique of attributive and communicating vein branches in surgery of arteriovenous fistula (AVF).   Method The clinical data consisted of 98 patients who received AVF of radial artery and cephalic vein by end-to-end anastomosis. The course of radial artery and cephalic vein was detected by ultrasonography before surgery in order to identify the attributive and communicating branches of cephalic vein. The patients were randomly divided into two groups according to the number of vein branches needed to be ligatured; group I received intradermic transfixion (n=52) and group II received dissection and ligation (n=46) to ligature the vein branches. The items including operation time, complication of surgery, degree of tumescence, degree of pain, ratio of infection, efficiency of ligation, and ratio of induration were compared between the two groups. Results The operation time of group I was shorter than that of group II, and this difference enlarged as the number of ligatured vein branches increased (F=45.586, P=0.000). The degree of pain was less severe in group I than in group II (Z=2.289, P=0.022). The ratio and size of induration were less in group I than in group II (X2=4.176, P=0.041). The degree of tumescence showed no statistical difference between the two groups, but approximated to the statistically significant area (Z=1.904, P=0.057). There were no statistical differences between the two groups regarding surgery complications, infection ratio and ligation efficiency.  Conclusion The intradermic transfixion is better than dissection and ligation, and should be preferably used in the ligation of attributive and communicating vein branches in AVF surgery.

Key words: Hemodialysis, Arteriovenous fistula, Hurgery procedure, Minimal Invasion, Collateral circulation