Comparison of Elective Minimally Invasive with Conventional Surgical Tracheostomy in Adults

Abstract

Minimally invasive techniques were used for tracheostomy including small horizontal skin incision, limited soft tissue dissection and no suturing. A Retrospective analysis of case sheets of patients who underwent elective tracheostomy by the first and second authors at M S Ramaiah Hospitals in Bangalore between 1st May 2010 and 1st May 2015 was done to compare the result of elective conventional open surgical tracheostomy using midline vertical skin incision with minimally invasive tracheostomy using a short horizontal incision. No statistically significant difference in the peri and post operative complication rate was found. The patterns of intra and post operative complications reflected the choice of the surgical technique-the conventional technique had problems associated with wide dissection, whereas the minimally invasive technique had problems associated with limited exposure. Problems of wound gaping, emphysema and peristomal inflammation were reduced with minimally invasive technique with short horizontal skin incision although statistical difference could not be shown. There was also no statistically significant difference with either technique regards death and decannulation rates. Minimally invasive technique of elective open surgical tracheostomy was found to be as safe as conventional open surgical tracheostomy with midline vertical skin incision in the studied groups.

Evaluation of Post-tracheostomy`s Scars and Its Impact on Persons Quality of Life: A Case Control Study

“…The length of skin incision for OST is varies from 2 to 5 cm in horizontal or vertical direction between the cricoid cartilage and sternal notch, depending on preferred by surgeon technique [2,6,7,21]. While a horizontal incision allows for improved healing and better cosmetic appearance, a vertical incision allows for extension of the incision and avoidance of the anterior jugular veins damage, but has worst cosmetic appearance [7,22].…”

“…A depressed tracheostomy scar can be aesthetically unacceptable, very distressing to the patient and affect the quality of life [7,10]. Despite the fact that minimally invasive tracheostomy technics with short horizontal skin incision usually healed with a small horizontal linear scar without signi cant puckering or irregularity, it is noted, that OST have more postoperational scarring incidence than PDT [7,13,15,22]. In the present study, no statistically signi cant difference was observed in the OST and PDT groups by the observer and patient component of POSAS.…”

The Comparative Changes in Inflammatory Markers Between Fiber Optic Bronchoscopy Guided and Classical Percutaneous Dilatational Tracheostomy

“…In the literature, various studies compare OST and PDT with or without bronchoscopy or radiologic assistance according to safety, efficacy, and costeffectivity (5,6,7). Even though PDT is claimed to be superior to OST it also induces an acute inflammatory response, and many complications like bleeding, pneumothorax or posterior tracheal wall perforation may occur in the early period (6,8). New techniques and devices like augmented reality-assisted percutaneous dilatational tracheostomy are utilized to overcome oversight problems and to decrease the potential risks with advances in technology (9, 10).…”

“…A systemic acute-phase reaction (APR) which is following systemic inflammatory response is induced after all types of tissue traumas including surgical procedures and tracheostomy (8,11). In the literature, numerous biomarkers like C-reactive protein (CRP), total leucocyte count (TLC) and neutrophil-lymphocyte ratio (NLR) are used to reflect the APR which is in accordance with the severity of the tissue trauma.…”

Analysis of 255 tracheostomies in an otorhinolaryngology-head and neck surgery tertiary care center: a safe procedure with a wide spectrum of indications

“…Tracheostomy is widely considered as one of the most established procedures in surgery [ 1 – 5 ]. Even though less invasive tracheostomy methods, such as percutaneous tracheostomy, have become more common, the traditional open surgical tracheostomy is the method of choice to secure the airway.…”