A clinical and histologic comparison of percutaneous dilational versus conventional surgical tracheostomy.
To directly compare percutaneous dilational tracheostomy (PDT) with conventional surgical tracheostomy, a prospective study was performed in 83 patients requiring tracheostomy for prolonged mechanical ventilation in the intensive care unit or after surgery for a large tumor in the upper respirodigestive tract. Median follow-up was 355 days after PDT and 338 days after conventional tracheostomy. The overall morbidity rate was significantly lower with PDT than with conventional tracheostomy (6.4% vs 36.1%; P < 0.001). Compared with conventional tracheostomy, PDT was also associated with a significantly lower incidence of postoperative bleeding (2.1% vs 13.9%; P < 0.05) and postoperative wound infection (0% vs 22.2%; P < 0.001). There were no clinical signs of laryngotracheal stenosis in either group. In conclusion, PDT is a simple, fast, safe bedside procedure that is associated with significantly lower morbidity than standard surgical tracheostomy.
Stoeckli
S J
SJ
Clinic of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich, Switzerland.
Breitbach
T
T
Schmid
S
S
D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications; D011446:Prospective Studies; D014132:Trachea / Q000601:surgery*; D014134:Tracheal Neoplasms / Q000473:pathology / Q000601:surgery*; D014139:Tracheostomy