Abstract | BACKGROUND: To compare surgical tracheostomy (ST) versus percutaneous dilatational tracheostomy ( PDT) in terms of complication rates. In particular we specifically studied the late tracheal complications of both methods by means of endoscopic controls of patients up to 6 months after the procedures. METHODS: DESIGN: prospective-randomized clinical study. SETTING: University-affiliated tertiary care referral hospital. PATIENTS: 50 consecutive translaryngeally intubated patients with respiratory failure were randomized to undergo either ST (25 patients) or endoscopic guided PDT (25 patients). RESULTS: ST was performed in 41+/-14 min versus 14+/-6 min for PDT (p<0.0001). There was no procedure-related death. In the ST group there were no intraoperative complications. In the PDT group 2 intraoperative complications (minor hemorrhages) were observed. In the ST group 9 early postoperative complications occurred: one minor bleeding, 7 stomal infections and one accidental decannulation. In the PDT group only one early postoperative complication (minor bleeding) occurred. Early postoperative complication rates were 36% for ST and 4% for PDT. In the ST group there were no late tracheal complications. In the PDT group 2 late tracheal complications (one segmental malacia and one stenosis at the level of the stoma) were observed. CONCLUSIONS: This study confirms that PDT is a simpler and quicker procedure than ST and that it has a lower rate of early postoperative complications. Late tracheal complications were more frequent, although the difference was not statistically-significant, in the PDT group. Further investigations of long-term outcome following PDT are therefore necessary.
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Authors | G Melloni, S Muttini, G Gallioli, A Carretta, S Cozzi, M Gemma, P Zannini |
Journal | The Journal of cardiovascular surgery
(J Cardiovasc Surg (Torino))
Vol. 43
Issue 1
Pg. 113-21
(Feb 2002)
ISSN: 0021-9509 [Print] Italy |
PMID | 11803342
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
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Topics |
- Adult
- Aged
- Catheterization
(adverse effects)
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Postoperative Complications
- Prospective Studies
- Respiratory Insufficiency
(pathology, therapy)
- Thoracoscopy
- Time Factors
- Tracheal Diseases
(etiology, pathology)
- Tracheostomy
(adverse effects)
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