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A comparative study of complications and long term outcomes of Surgical Tracheostomy and two techniques of Percutaneous Tracheostomy

CONTEXT: The operative technique for surgical tracheostomy has remained unchanged, but different techniques for percutaneous tracheostomy have evolved due to interest in minimally invasive procedures for the critically ill patient. AIMS: To compare the periprocedural complications and long term outc...

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Autores principales: Kiran, S., Eapen, S., Chopra, Vivek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339909/
https://www.ncbi.nlm.nih.gov/pubmed/25722549
http://dx.doi.org/10.4103/0972-5229.151015
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author Kiran, S.
Eapen, S.
Chopra, Vivek
author_facet Kiran, S.
Eapen, S.
Chopra, Vivek
author_sort Kiran, S.
collection PubMed
description CONTEXT: The operative technique for surgical tracheostomy has remained unchanged, but different techniques for percutaneous tracheostomy have evolved due to interest in minimally invasive procedures for the critically ill patient. AIMS: To compare the periprocedural complications and long term outcomes of bedside surgical tracheostomy (ST) with two percutaneous tracheostomy (PCT) techniques, namely serial guide wire dilating forceps (GWDF) and PercuTwist (PT). SETTINGS AND DESIGN: This prospective observational study was carried out in ICU of a tertiary referral centre over three year period on adult intubated patients needing elective tracheostomy. MATERIALS AND METHODS: Patients with anticipated difficult neck anatomy were assigned for ST based on discretion of intensivist. Patients included for PCT were randomly assigned to the GWDT and PT technique. 90 patients underwent either bedside ST (n = 30), PCT by GWDF technique (n = 30) or PCT with PercuTwist (n = 30) and were followed up with fibreoptic bronchoscopy monthly for 06 months. STATISTICAL ANALYSIS USED: Data was analyzed by applying chi square tests for categorical variables. RESULTS: Periprocedural complications during PCT included major bleeding (>100ml) in two patients in GWDF group which required conversion to ST. Periprocedural bleeding was also the main complication in ST. Increased incidence of granulation tissue and tracheal narrowing in long term was seen in both ST and PCT groups. All of the P values analysed for the intra operative, post operative complications or long term outcomes were >0.05. CONCLUSIONS: There was no statistically significant difference in incidence of complications of ST and two techniques of PCT. Proper case selection makes PCT as safe as ST.
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spelling pubmed-43399092015-02-26 A comparative study of complications and long term outcomes of Surgical Tracheostomy and two techniques of Percutaneous Tracheostomy Kiran, S. Eapen, S. Chopra, Vivek Indian J Crit Care Med Research Article CONTEXT: The operative technique for surgical tracheostomy has remained unchanged, but different techniques for percutaneous tracheostomy have evolved due to interest in minimally invasive procedures for the critically ill patient. AIMS: To compare the periprocedural complications and long term outcomes of bedside surgical tracheostomy (ST) with two percutaneous tracheostomy (PCT) techniques, namely serial guide wire dilating forceps (GWDF) and PercuTwist (PT). SETTINGS AND DESIGN: This prospective observational study was carried out in ICU of a tertiary referral centre over three year period on adult intubated patients needing elective tracheostomy. MATERIALS AND METHODS: Patients with anticipated difficult neck anatomy were assigned for ST based on discretion of intensivist. Patients included for PCT were randomly assigned to the GWDT and PT technique. 90 patients underwent either bedside ST (n = 30), PCT by GWDF technique (n = 30) or PCT with PercuTwist (n = 30) and were followed up with fibreoptic bronchoscopy monthly for 06 months. STATISTICAL ANALYSIS USED: Data was analyzed by applying chi square tests for categorical variables. RESULTS: Periprocedural complications during PCT included major bleeding (>100ml) in two patients in GWDF group which required conversion to ST. Periprocedural bleeding was also the main complication in ST. Increased incidence of granulation tissue and tracheal narrowing in long term was seen in both ST and PCT groups. All of the P values analysed for the intra operative, post operative complications or long term outcomes were >0.05. CONCLUSIONS: There was no statistically significant difference in incidence of complications of ST and two techniques of PCT. Proper case selection makes PCT as safe as ST. Medknow Publications & Media Pvt Ltd 2015-02 /pmc/articles/PMC4339909/ /pubmed/25722549 http://dx.doi.org/10.4103/0972-5229.151015 Text en Copyright: © Indian Journal of Critical Care Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Kiran, S.
Eapen, S.
Chopra, Vivek
A comparative study of complications and long term outcomes of Surgical Tracheostomy and two techniques of Percutaneous Tracheostomy
title A comparative study of complications and long term outcomes of Surgical Tracheostomy and two techniques of Percutaneous Tracheostomy
title_full A comparative study of complications and long term outcomes of Surgical Tracheostomy and two techniques of Percutaneous Tracheostomy
title_fullStr A comparative study of complications and long term outcomes of Surgical Tracheostomy and two techniques of Percutaneous Tracheostomy
title_full_unstemmed A comparative study of complications and long term outcomes of Surgical Tracheostomy and two techniques of Percutaneous Tracheostomy
title_short A comparative study of complications and long term outcomes of Surgical Tracheostomy and two techniques of Percutaneous Tracheostomy
title_sort comparative study of complications and long term outcomes of surgical tracheostomy and two techniques of percutaneous tracheostomy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339909/
https://www.ncbi.nlm.nih.gov/pubmed/25722549
http://dx.doi.org/10.4103/0972-5229.151015
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