Late Consequences of Classical
Tracheotomy and Percutaneous Dilatation Tracheotomy
Praženica P., Holý R., Filipovský T., Fuksa Z.*, Limberk B.**, Navara M.
Otorinolaryngologické oddělení, Ústřední vojenská nemocnice, Praha, přednosta pplk. MUDr.M. Navara Oddělení intenzivní péče chirurgických oborů, Ústřední vojenská nemocnice, Praha, přednosta plk. MUDr. Z. Fuksa* Anesteziologicko-resuscitační oddělení, Ústřední vojenská nemocnice, Praha, přednosta plk. MUDr. B. Limberk** |
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Summary:
The authors present the results of a retrospective study comparing long-term
consequences of classical tracheotomy (TT) and percutaneous dilatation tracheotomy (PDT). In the
period from 1/1995 till 12/2000 the classical tracheotomy was made at the emergency ward in 256
patients and in the period of 1/1998 till 12/1999 a total of 224 percutaneous dilatation tracheotomy
interventions 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 the
second 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 complaints
were reported by 12% of patients in the TT group and 10% in the PDT group (without statistical
significance, P < 0.05). The incidence of cosmetically disturbing scar appeared to be higher in the
PDT 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 pathological
findings of different degrees in 19% of patients (without statistical significance, P < 0.05). Laryngotracheal
stenosis was present in the TT group in 25% and in 29% in the PDT group (without
significant difference, P < 0.05). The incidence of tracheal stenosis and a cosmetically disturbing
scar was significantly influenced by duration of canula insertion (P < 0.05), but there was not any
statistically significant correlation between the incidence of the cosmetically disturbing scar and
tracheal stenosis (P < 0.05). The results of our work indicate that from the standpoint of long-term
consequences, especially in view of the development of laryngo-tracheal stenosis, both methods
appear to be equal.
Key words:
tracheotomy, percutaneous tracheotomy, complications, stenosis.
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