Is Tracheal Stenosis Caused by Percutaneous Tracheostomy Different From That by Surgical Tracheostomy?

Govindan, Ramaswamy; Rajan, Sunil; Marzouk, Joseph; Mullhi, D.; Smith, Fang Gao

doi:10.1378/chest.127.3.879

Cited by 54 publications

(49 citation statements)

References 20 publications

(31 reference statements)

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“…In a study, predating the widespread introduction of PDT, assessing the impact of prolonged tracheal intubation and tracheostomy, Stauffer et al (15) identified a high prevalence of complications associated with ST (36% for stomal bleeding, 36% for stomal infection) and a 65% TS prevalence. Despite a number of moderate-sized case series from tertiary centers reporting of the management of TS, none have specifically looked at the role of perioperative events in the initiation of TS (16)(17)(18)(19). The only perioperative event that has been postulated to have a role in the genesis of TS is tracheal ring fracture.…”

mentioning

confidence: 99%

“…The only perioperative event that has been postulated to have a role in the genesis of TS is tracheal ring fracture. Although a number of authors (19)(20)(21) have suggested that tracheal ring fracture may be of significance, this is not necessarily borne out within large cohort studies (9). Further studies have considered a role for infection in the initiation of TS.…”

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confidence: 99%

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Long-Term Outcome Following Tracheostomy in Critical Care

Dempsey

Morton

Hammell

et al. 2016

Critical Care Medicine

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Considering comparative data, there was no significant difference in the prevalence of tracheal stenosis or major bleeding between percutaneous and surgical tracheostomy. In relation to wound infection, we have found a reduction associated with the original Ciaglia technique when compared with that with the surgical tracheostomy. Considering all published data reporting long-term outcomes pooled proportion meta-analysis indicates a trend toward a higher rate of tracheal stenosis and an increased risk of major bleeding and wound infection for surgical tracheostomies. This finding may be biased as a result of targeted patient selection, and further, high-quality long-term comparative data are needed to confirm these findings.

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confidence: 99%

mentioning

confidence: 99%

Long-Term Outcome Following Tracheostomy in Critical Care

Dempsey

Morton

Hammell

et al. 2016

Critical Care Medicine

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“…56 In this regard, Raghuraman et al reported that, although similar in incidence, size, and severity, the tracheal stenosis resulting from a PCT differed from those arising from an open surgical tracheostomy in at least 3 very specific ways: PCT-related stenosis tended to occur earlier (5 weeks versus 28 weeks, P ϭ 0.009), were far more likely to involved the subglottic region (within 5 mm of the vocal cords), and were associated with a much higher incidence of cartilage fracture. 57 This higher incidence of cartilage fracture with PCT had been described before, both in PCT done by dilational techniques 58,59 as well as in those done with the Griggs forceps technique. 60 A prospective randomized trial that followed patients for 1 year in a double blind manner compared those that underwent tracheostomy with either the Fantoni translaryngeal technique (TLT) or surgical tracheostomy.…”

Section: How Should Tracheostomy Be Done?mentioning

confidence: 53%

Tracheostomy in the Critically Ill Patient: Who, When, and How?

Zgoda

Berger

2006

Clinical Pulmonary Medicine

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Tracheostomy in the ICU has evolved into a bedside procedure being done by nonsurgeons and is becoming more popular among intensivists worldwide as a means of controlling the airway in critically ill patients. This review article evaluates the current literature that addresses on whom, when, and with which technique this procedure is being performed. Europe and the United States have similar practices of whom and when a tracheostomy should be performed; however, the Europeans have more experience with the various percutaneous tracheostomy techniques. Thus far, the literature favors the use of tracheostomy in those patients with an expected mechanical ventilation time ranging from 1 to 2 weeks, but early tracheostomy in this group suggests a favorable trend toward fewer ventilator days, ICU days, and overall costs. Percutaneous tracheostomy is the preferred method for bedside tracheostomy tube placement in the ICU, but the method is still evolving and the best technique has yet to be defined.

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“…Kadavrada yapılan bir çalışmada önemli derecede peristomal mukoza yırtığı ve kıkır-dak kırığı saptanmıştır (14) . Kıkırdak kırıkları işlem sırasında veya işlem sonrası ventilatör bağlantılarının trakeal açıklık etrafında uyguladığı baskı nedeniyle de oluşabilir (13,15) .…”

Section: Discussionunclassified