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Indian Journal of Anesthesia and Analgesia

Volume  5, Issue 11, November 2018, Pages 1829-1834
 

Original Article

A Prospective Randomized Study of Percutaneous Tracheostomy versus Surgical Tracheostomy

Himanshu A. Shah1, Amit P. Chauhan2, Jaimin M. Pandya3

1Professor, Department of Anaesthesiology & Consultant Cardiac Anaesthetist 2Assistant Professor, Department of Anesthesia and Critical Care 3Assistant Professor, Department of Anaesthesiology, Parul Institute of Medical Science & Research, Waghodia, Vadodara, Gujarat 391760, India

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51118.9

Abstract

  Aim: Aim of study was to compare Percutaneous Tracheostomy ( PT) and Surgical Tracheostomy (ST) both for complications, duration of procedure ,cost and easy of doing it. Objective of our study was to find out time taken to heal tracheal stoma. Method: 100 of Tracheostomy patients were randomly divided in to two groups (n =50 for both groups) with confidence level of 95%. Two consultants allocated 25 patients of each group for to do procedure. Procedure­related variables (length of skin incision, duration, difficulty), early complications like ‘bleeding & trauma, pneumothorax, pneumomediastinum, subcutaneous emphysema, loss of airway’, vitals, economic aspects were evaluated by the operating consultant. Procedure related (up to14 days) complications like local infection, haematoma & bleeding, trachea­innominate fistula, tracheo­esophageal fistula, were evaluated daily by consultant blinded to the technique used. Air leak closure/healing and long­term complications like cosmetic deformity, tracheal stenosis, tracheomalacia, delayed stomal healing were evaluated 3 months after decannulation by another consultant blinded to the surgical technique. Results: PT had more incidence of minor perioperative complications and ST had more long­term complications, statistical significance between two groups was absent. Time taken to perform PT and tissue trauma with PT were lesser than ST Group. Vitals were better maintained with PT Group. Air leak closure after decannulation was earlier in PT group and aesthetically, scar was smaller with PT group. Conclusion: PT was preferrable because of lesser duration of procedure, smaller incision with comparable complication rate and faster stomal healing. 


Keywords : Complications; Cost; Healing; Percutaneous Tracheostomy; Randomized Trial; Surgical Tracheostomy
Corresponding Author : Himanshu A. Shah, Professor, Department of Anaesthesiology & Consultant Cardiac Anaesthetist, Parul Institute of Medical Science & Research, Waghodia, Vadodara, Gujarat 391760, India.