gms | German Medical Science

Objective: Percutaneus tracheostomy seems to be a simple and quick method, which is more and more common in anaestheology and intensive care units. Surgical tracheostomy is a long introduced method for intensive care units but nevertheless needs surgery with all medical equipment. Aim of the study was to find out which of the chosen surgical procedure had a lower compication rate and seemed to be saver.

Methods: In the years from 1996 to 2013 we performed all together 310 tracheostomies, all done by surgical tracheotomy. In the same period 18 cases with serious complications from percutaneus tracheostomies were transferred to our hospital and required surgical intervention. We tried to evaluate the pitfalls from transcutaneus and surgical procedure.

Results: In 310 surgical tracheostomies we had 6 (1,9%) complications: 4 bleedings, 1 tracheomalacia, 1 perichondritis. There were no mortality, in 34 (11%) cases was a surgical closure necessary, all other cases closed spontaneously.

In these 18 cases with serious complications from percutaneus tracheostomis were 13 ruptures of the pars membranacea, 4 cases of late trachealstnosis, 1 sever bleeding. All cases needed surgical intervention, 2 cases died postoperativly.

Conclusion: As we don’t have any data of percutaneus tracheostomy in our department, we are not able to perform statistical analysis. In the literature there are data pro and con but due to these severe complications treated in our surgical department we emphasize that the method of percutaneus tracheostomy imply the chance of serious complications, which are not avoidable. As long as a surgical tracheostomy can be performed it should be the method of choice.