Does a percutaneous tracheostomy have a lower incidence of complications compared to an open surgical technique?

Abstract

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was which method of tracheostomy had fewer complications, the surgical or percutaneous technique. A total of 264 papers were identified of which 13 provided the best evidence to answer the question. The author, journal, date and country of publication, patient group, relevant outcomes and weaknesses were tabulated. We conclude that both percutaneous and surgical tracheostomy have overall a low incidence of complications. There is a lower incidence of procedural complications when inserted surgically. There is a lower incidence of post-procedural complications when inserted via the percutaneous route.

Early complications of tracheostomy: a study on 100 patients at a single tertiary care centre

“…7,9 Most of the tracheostomies are performed electively, while few are done as an emergency procedure. 10 In our series of 100 cases too, 73% were elective and 27% were performed as an emergency procedure. Common indications for elective tracheostomy include prolonged ventilator dependence, tracheal toileting and foreign body aspiration, while emergency tracheostomy is performed for upper airway obstruction due to laryngeal neoplasms, maxillofacial or laryngeal trauma, burns and upper airway infection.…”

Comparative study on complications of emergency and elective tracheostomy

“…In other study in Bangladesh this complications for elective tracheostory was 9.99% & emergency tracheostomy was 33.35% 3 . Study of Goldenberg D reported complications were more common in cases of emergency tracheostomy (43.26%) than elective (17.8%), total complications was 39.05% 10 .…”

“…In other study surgical emphysema was commonest complications both for elective (3.33%) & emergency tracheostomy (10%) 3 In another study. Rates of surgical emphysema and in elective tracheostomy as, 5% 9 , complications surgical emphysema is the commonest complication followed by haemorrhage 10 . These findings are consistent with results of this study however the rates of these complications differ from the other study 11 .…”

Perioperative management in myasthenia gravis: republication of a systematic review and a proposal by the guideline committee of the Japanese Association for Chest Surgery 2014

“…Generally, a tracheostomy should be avoided within 2 weeks after open-heart surgery because of the high risk of mediastinitis [140][141][142][143][144][145][146][147][148]. On the other hand, high tracheostomy or percutaneous tracheostomy through the cricothyroid membrane is reported to reduce the risk of mediastinitis.…”