Open vs percutaneous tracheostomy

Abstract

Introduction: Tracheostomy is indicated to prevent laryngeal injury in cases of long-term translaryngeal intubation, to improve tracheal hygiene, decrease the dead space and reduce the time spent in intensive care units (ICU). The open technique is the most commonly used technique, which allows for an adequate control of anatomy and haemostasis. Currently, the percutaneous technique is increasingly used in CPUs, since it is a fast technique, with less perioperative complications. However, there is still controversy on this issue. Aim: This paper is a prospective study, designed to compare both techniques in terms of procedure duration and peri- and postoperative complications. Material and method: Out of a total of 91 patients, 50 were selected that did not have any counterindications for the percutaneous technique. These 50 patients were randomly assigned to either the open or the percutanous technique groups, obtaining 2 groups of 25 patients (Groups A and P). All patients had the surgery performed in the operating room, under general anesthesia. Results: Total duration of the procedure (including anesthesia) was 65.8 and 59.2 min, and surgery duration was 40.4 and 32.2 min, respectively. Perioperative complications were: Group A, 16% (oxygen desaturation and bleeding were the more frequent problems), and Group P, 40% (oxygen desaturation and airway loss were the more frequent problems). Postoperative complications in Groups A and P were 8 and 12% (bleeding and infection being the more frequent problems in both groups), respectively. Conclusion: In our study, a comparison of both techniques did not show significant differences regarding either number of complications or duration of the procedure.