Parma tracheostomy technique: a hybrid approach to tracheostomy between classical surgical and percutaneous tracheostomies.
BACKGROUND
The aim of our study is to compare the classical surgical tracheostomy (TT) technique with a modified surgical technique designed and created by the cardiothoracic surgery staff of our department to reduce surgical trauma and postoperative complications. This modified technique combines features of percutaneous TT and surgical TT avoiding the use of specialized tools, which are required in percutaneous TT.


METHODS
From October 2008 to March 2014 we performed 67 tracheostomies using this New Modified Surgical Technique (NMST) and 56 TT with the Classical Surgical Technique (CST). We collected data about the early clinical complications, deaths TT-related, deaths due to other complications and the presence of late TT's complications were performed by a telephone follow-up. SPSS software (IMB version 21) was used for the statistical analysis. Categorical data were treated with chi-square test and continuous data were treated witht-test for independent samples.


RESULTS
NMST group had a significant lower number of early complications (P=0.005) compared to CST group (5vs. 15). In-hospital mortality was significantly higher in CST group (18 deathsvs. 4 in NMST group, P=0.001) but we registered only one case of TT-related mortality in CST group (P=0.280). We did not note other differences between the two groups regarding short or mid-long term complications.


CONCLUSIONS
In our experience the NMST demonstrated to be easily safe and reproducible with an amount of early, mid- and long-term complications similar to the CST; furthermore the aesthetic results of the procedure appear similar to those of percutaneous TT.
Department of General and Specialistic Surgery, Section of Cardiac Surgery, Parma University Hospital, Parma, Italy.
Alberto
A
Molardi
Department of General and Specialistic Surgery, Section of Cardiac Surgery, Parma University Hospital, Parma, Italy.
Filippo
F
Benassi
Department of General and Specialistic Surgery, Section of Cardiac Surgery Intensive Care, Parma University Hospital, Parma, Italy.
Tullio
T
Manca
Department of General and Specialistic Surgery, Section of Cardiac Surgery Intensive Care, Parma University Hospital, Parma, Italy.
Andrea
A
Ramelli
Department of General and Specialistic Surgery, Section of Cardiac Surgery Intensive Care, Parma University Hospital, Parma, Italy.
Antonella
A
Vezzani
Parma Medical School, University of Parma, Parma, Italy.
Francesco
F
Nicolini
Parma Medical School, University of Parma, Parma, Italy.
Giorgio
G
Romano
Parma Medical School, University of Parma, Parma, Italy.
Matteo
M
Ricci
Parma Medical School, University of Parma, Parma, Italy.
Davide
D
Carino
Parma Medical School, University of Parma, Parma, Italy.
Maria Vincenza
MV
Di Chicco
Parma Medical School, University of Parma, Parma, Italy.
Tiziano
T
Gherli
Tracheostomy (TT); cardiac surgery; intensive care unit; new technique; respiratory failure