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  • Title: [Percutaneous dilatative tracheostomy versus conventional surgical tracheostomy: a retrospective trial].
    Author: Stripf T, Ali M, Mewes T, Mann WJ.
    Journal: Laryngorhinootologie; 2003 Apr; 82(4):281-5. PubMed ID: 12717604.
    Abstract:
    BACKGROUND: In this retrospective study we compared endoscopically controlled percutaneous dilatative tracheostomies (PDT) with conventional surgical tracheostomies as a bedside procedure and in the operating theatre. PATIENTS: Between 1998 and 2000 we performed 360 tracheostomies electively, 152 in PDT-technique (42 %) and 208 (58 %) with the conventional procedure. Referring to the PDT-technique 74 % (n = 112) were performed at the bedside and 26 % in the operating theatre. The conventional tracheostomies took place at bedside in 53 % (n = 110) and in the operating theatre in 47 % (n = 98) of the cases. The complications were divided in 5 groups with special interest if the operation took place in the operating theatre or as a bedside procedure. RESULTS: In general the rate of complications in the PDT group was 33 % (50/152) versus 22 % (46/208) referring to the conventional group. Referring to the PDT group the rate of complications were 35 % (39/112) at the bed site procedure and 28 % (11/40) in the operating theatre. The complication rate for the conventional group was 27 % (30/110) as a bedside procedure versus 16 % (16/98) in the operating theatre. Significant differences were found for the PDT with an increase of tubal obstructions (p = 0.007). For the conventional tracheostomy we found a significant increase of wound infections (p = 0.006). There was significantly higher postoperative hemorrhage if the procedure was done at bed site. CONCLUSION: PDT and conventional tracheostomies have different complications. The higher risk of postoperative hemorrhage for bed site procedure has to be considered.
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