Abstract
Objectives/Hypothesis:
Percutaneous tracheotomy is progressively replacing open tracheotomy as a consequence of promising results of comparative studies. However, this comparison has four considerable weaknesses: 1) selected indications (high‐risk patients excluded for percutaneous tracheotomy); 2) varying spectra of complications included in different studies; 3) varying operative settings (experienced surgeons exclusively, surgeons in training, or both); and 4) missing differentiation between different surgical techniques. Our study was performed to collect complete datasets of unselected patients who all underwent a tracheotomy in a uniform technique in an academic teaching hospital setting.
Methods:
Retrospective evaluation of all complications following 303 consecutive surgical tracheotomies (midline‐open technique) performed by different surgeons and surgeons in training at one academic institution. Complications were classified and compared to results in the literature.
Results:
Rates of 21.5% minor and 1.0% major complications and 0% tracheotomy‐related mortality were registered. The most prevalent complications were local wound infections (10.9%), intra‐ and postoperative hemorrhages (4.2%), and cartilage damage (1.7%). No significant difference was found for high‐risk patients and emergency tracheotomies.
Conclusions:
Our study demonstrates that open tracheotomy is a safe procedure, particularly if performed in high‐risk patients even by inexperienced surgeons. Therefore, we emphasize the advantages of the midline‐open tracheotomy in an academic teaching hospital setting. Laryngoscope, 2010