Do you refactor so often that this actually becomes one of your main issues? Simple refactoring can be done with :argdo or :bufdo in combination with :%s. For more advanced cases, I know there are plugins for at least some languages. I use ropevim (http://rope.sourceforge.net/ropevim.html) for Python, and its refactoring tools are very good. I suspect there are similar tools for other languages, but I've never used any.