Conventional Tracheotomy Versus Percutaneous Tracheotomy

Objectives: Percutaneous tracheotomy is a relatively new technique which is considered as an alternative to conventional tracheotomy. While both techniques have their own advantages and disadvantages, the data relat-ed to long-term follow-up after percutaneous dilational tracheotomy (PDT) and its late complications are limited in the literature. The aim of this study is to compare both techniques according to the complications, patients’ epi-demiological situations, intubation duration, coagulopa-thy, mortality rates and cost-effectiveness. Patients and Methods: We retrospectively evaluat-ed 236 tracheotomy cases perfomed at our hospitalbetween 1995-2007. Results: There was statistically significant difference in complication rates between open and percutaneous tracheotomy techniques (p=0.001). Major complica-tions (TOF, tracheal stenosis, hemorrhage) were mostly related to PDT. However, stomal infection, stomal granu-lation tissue formation and cannula obstruction due to mucoid debris was more frequent in the open technique group. The mortality rate was found to be higher in the PDT group. Positive bacterial cultures on deep tracheal aspirations were significantly increasing the complication rates. Open technique costs were nearly twice that of percutaneous technique. Conclusion: Major complications are more common with percutaneous tracheotomy compared to open tech-nique tracheotomy according to our study results. Since in some cases PDT may necessarily be converted into an open technique; a surgically talented and equipped staff should perform this method.