title: Percutaneous versus surgical strategy for tracheostomy: protocol for a systematic review and meta-analysis of perioperative and postoperative complications.
abstract: BACKGROUND
  Tracheostomy is one of the most frequently performed procedures in intensive care medicine. The two main approaches to form a tracheostoma are the open surgical tracheotomy (ST) and the interventional strategy of percutaneous dilatational tracheotomy (PDT). It is particularly important to the critically ill patients that both procedures are performed with high success rates and low complication frequencies. Therefore, the aim of this systematic review is to summarize and analyze existing and relevant evidence for peri- and postoperative parameters of safety.
  
  
  METHODS
  A systematic literature search will be conducted in The Cochrane Library, MEDLINE, LILACS, and Embase to identify all randomized controlled trials (RCTs) comparing peri- and postoperative complications between the two strategies and to define the strategy with the lower risk of potentially life-threatening events. A priori defined data will be extracted from included studies, and methodological quality will be assessed according to the recommendations of the Cochrane Collaboration.
  
  
  CONCLUSIONS
  The findings of this systematic review with proportional meta-analysis will help to identify the strategy with the lowest frequency of potentially life-threatening events. This may influence daily practice, and the data may be implemented in treatment guidelines or serve as the basis for planning further randomized controlled trials. Considering the critical health of these patients, they will particularly benefit from evidence-based treatment.
  
  
  BACKGROUND
  PROSPERO CRD42015021967.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. rosa.klotz@med.uni-heidelberg.de.|Study Center of the German Surgical Society (SDGC), University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. rosa.klotz@med.uni-heidelberg.de.
authors.forename: Rosa
authors.initials: R
authors.lastname: Klotz
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. ulla.klaiber@med.uni-heidelberg.de.|Study Center of the German Surgical Society (SDGC), University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. ulla.klaiber@med.uni-heidelberg.de.
authors.forename: Ulla
authors.initials: U
authors.lastname: Klaiber
authors.affiliation: Study Center of the German Surgical Society (SDGC), University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. kathrin.grummich@med.uni-heidelberg.de.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Grummich
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. pascal.probst@med.uni-heidelberg.de.|Study Center of the German Surgical Society (SDGC), University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. pascal.probst@med.uni-heidelberg.de.
authors.forename: Pascal
authors.initials: P
authors.lastname: Probst
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. markus.diener@med.uni-heidelberg.de.|Study Center of the German Surgical Society (SDGC), University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. markus.diener@med.uni-heidelberg.de.
authors.forename: Markus K
authors.initials: MK
authors.lastname: Diener
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. markus.buechler@med.uni-heidelberg.de.|Study Center of the German Surgical Society (SDGC), University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. markus.buechler@med.uni-heidelberg.de.
authors.forename: Markus W
authors.initials: MW
authors.lastname: Büchler
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. phillip.knebel@med.uni-heidelberg.de.|Study Center of the German Surgical Society (SDGC), University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. phillip.knebel@med.uni-heidelberg.de.
authors.forename: Phillip
authors.initials: P
authors.lastname: Knebel
mesh_terms: D002985:Clinical Protocols; D003422:Critical Care; D016638:Critical Illness / Q000628:therapy*; D006801:Humans; D061214:Patient Safety; D011183:Postoperative Complications / Q000209:etiology*; D012107:Research Design; D000078202:Systematic Reviews as Topic; D014132:Trachea / Q000601:surgery; D014139:Tracheostomy / Q000379:methods*; D015201:Meta-Analysis as Topic