One

Lipectomy is an acceptable method of cephalic vein superficialization in hemodialysis arteriovenous fistula. However, limiting it to be a secondary procedure may prolong time between fistula creation and successful cannulation posing more risk of central venous catheter use. The aim of this study is to evaluate primary surgical lipectomy performed at the time of arteriovenous fistula creation in comparison with secondary lipectomy. Between June 2015 and January 2017, 59 adult end-stage renal disease patients were allocated non-randomly to group I, 35 patients had arteriovenous fistula with primary lipectomy of forearm or arm deep cephalic veins, and group II, 24 patients who had secondary lipectomy of deep forearm or arm cephalic veins after primary arteriovenous fistula. Mean body mass index was 28.2？±？3.2？kg/m2 versus 29.4？±？2.5？kg/m2 in group I versus II, respectively. Mean time from fistula creation to cannulation was 6？±？0.5？weeks in group I versus 14.5？±？5.5？weeks in group II (p？<？0.0001*). Immediate technical success was achieved in all cases in both groups. Clinical success was 94.29% (33/35) versus 91.67% (22/24) in group I versus II, respectively. Cumulative 1-year primary patency rate was 88% in primary and 86.47% in secondary lipectomy; p？=？0.842. Lipectomy is a minimally invasive procedure carried out through small incision(s). Primary and secondary lipectomy procedures have few complications, and acceptable technical and clinical success rates. Primary lipectomy has the advantage to hasten fistula use and diminish central venous catheter dependency