Late Consequences of ClassicalTracheotomy and Percutaneous Dilatation Tracheotomy

Overview

The authors present the results of a retrospective study comparing long-termconsequences of classical tracheotomy (TT) and percutaneous dilatation tracheotomy (PDT). In theperiod from 1/1995 till 12/2000 the classical tracheotomy was made at the emergency ward in 256patients and in the period of 1/1998 till 12/1999 a total of 224 percutaneous dilatation tracheotomyinterventions according to Griggs were made at the Ward for Intensive Care of Surgical Branches.The study included 32 randomly selected patients from the first group and 21 patients from thesecond group. The authors evaluated subjective complaints, state of the scar on the neck, functional finding of respiratory pathways and the endoscopic laryngo-tracheal finding. Subjective complaintswere reported by 12% of patients in the TT group and 10% in the PDT group (without statisticalsignificance, P < 0.05). The incidence of cosmetically disturbing scar appeared to be higher in thePDT group (62%) than in the TT group (44%), but the difference was not significant (P < 0.05).A functional examination of respiratory pathways was the same in both groups with pathologicalfindings of different degrees in 19% of patients (without statistical significance, P < 0.05). Laryngotrachealstenosis was present in the TT group in 25% and in 29% in the PDT group (withoutsignificant difference, P < 0.05). The incidence of tracheal stenosis and a cosmetically disturbingscar was significantly influenced by duration of canula insertion (P < 0.05), but there was not anystatistically significant correlation between the incidence of the cosmetically disturbing scar andtracheal stenosis (P < 0.05). The results of our work indicate that from the standpoint of long-termconsequences, especially in view of the development of laryngo-tracheal stenosis, both methodsappear to be equal.

Key words:
tracheotomy, percutaneous tracheotomy, complications, stenosis.