Tracheotomia percutanea e chirurgica. Confronto prospettico, randomizzato dell'incidenza di complicanze precoci e tardive.

Translated title of the contribution: Percutaneous or surgical trachetomy. Prospective, randomized comparison of the incidence of early and late complications

S. Muttini, G. Melloni, M. Gemma, A. Casati, A. Carretta, D. Giudici, S. Cozzi, G. Chiesa, G. Gallioli, L. Beretta, E. Casaletti, G. Torri

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: To compare early and late complications after either conventional surgical or percutaneous dilatational tracheostomy. DESIGN: Prospective, randomized study. SETTING: General intensive care unit and neuro-surgical intensive care unit in a university hospital. PATIENTS: 50 consecutive patients, requiring tracheostomy for prolonged mechanical ventilation. INTERVENTIONS AND MEASUREMENTS: Patients were randomly allocated to receive either surgical (surgical group, n = 25) or percutaneous dilatational tracheostomy (percutaneous group, n = 25). Occurrence of perioperative complication were carefully evaluated during ICU stay. Late complications were evaluated with both physical and endoscopic examination at 1, 3 to 6 months after tracheostomy. RESULTS: All surgical and percutaneous tracheostomies were successfully completed and no deaths directly related to the tracheostomy procedures were reported. Completion of the procedure required 41 +/- 14 min in the surgical group and 14 +/- 6 min in the percutaneous one (p <0.0001). The incidence of early perioperative complications was higher in the surgical group (36%) than in percutaneous one (12%), (p <0.05). The endoscopic follow-up demonstrated one segmental malacia and one stenosis of the trachea in the percutaneous group only (p = n.s.). Skin repair was better after percutaneous tracheostomy than in the surgical group (p <0.01). CONCLUSIONS: In experienced hands, percutaneous dilatational tracheostomy is as safe and effective as the conventional surgical tracheostomy. The percutaneous technique is less time-consuming and has a lower rate of early infectious complications with better cosmetic results than the surgical technique.

Translated title of the contributionPercutaneous or surgical trachetomy. Prospective, randomized comparison of the incidence of early and late complications
Original languageItalian
Pages (from-to)521-527
Number of pages7
JournalMinerva Anestesiologica
Volume65
Issue number7-8
Publication statusPublished - Jul 1999

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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