Complications of the Percutaneous Dilatational Tracheostomy and Surgical Tracheostomy. AreBoth Methods Equally Safe?

Overview

Objective:
Comparison of complications of percutaneous (PDT) and surgical tracheostomies (ST).Design: Retrospective study.Setting: Department of ENT and Department of Anaesthesiology and Intesive Care, Hospital Frýdek-Místek, Department ofENT and Department of Anaesthesiology and Intensive Care, Hospital Pardubice.Material and Method: Retrospective study of patients, who underwent tracheostomy in hospitals Frýdek-Místek andPardubice from 1998 to 2002 was conducted. The incidence of early and late complications of PDT and ST was observed.The relation of complications and techniques and also between complications and timing of ST was observed. The resultswere analysed by the Fisher exact test (α = 0.05).Results: 561 ST and 106 PDT were performed. Early complications were observed in 11.3% in the PDT group and 4.8% inthe ST group (P < 0.05). Early bleeding was found if 8.5% if the PDT group and in 1.6% in the ST group (P < 0.05). Latecomplications after performing of the mucocutaneus anastomosis were observed in 18% and in 6.1% of ST withoutanastomosis (P < 0.05). Late complications were found in 11.1% after division of thyroid isthmus and in 5% without it(P < 0.05).Conclusion: PDT was associated with a higher rate of early complications and a higher rate of early bleeding than ST.A higher rate of late complications of ST was observed after division of the thyroid isthmus and after performing of themucocutaneous anastomosis.

Key words:
surgical tracheostomy – percutaneous dilatational tracheostomy – complication