A comparison of percutaneous dilatational tracheostomy versus conventional surgical tracheostomy.

BACKGROUND: Percutaneous dilatational tracheostomy (PDT) and surgical tracheostomy (ST) are widely accepted techniques and frequently performed in clinical practice. We compared PDT with ST tracheostomies in view of the benefits and drawbacks, time of duration, indication and complication rate of the respective procedures.
METHODS: The evaluation was based on data from 378 tracheostomies. 209 of these tracheostomies were performed at bedside as PDT in the intensive care unit. These were compared to 169 ST tracheostomies performed in the operating room. All interventions were performed by the same team of surgeons or intensivists, however, at different training levels.
RESULTS: The mean duration of the operation was shorter for PDT than for ST (18.2 ± 10 min versus 38.2 ± 14.2 min, p = < 0.001). The PDT was a simpler procedure and performed predominantly by physicians in postgraduate training. The rate of complications was low in both groups (8.6 % PDT, 8.3 % ST, p = 0.909).
CONCLUSION: Although both interventions are safe and achieve comparable results, PDT can be applied in a shorter time. PDT is easier to perform and seems particularly suitable for physicians in postgraduate training. © Georg Thieme Verlag KG Stuttgart · New York.