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Comparison between percutaneous and surgical tracheostomy, a single-center experience in Mexico City

Martínez-Salas, Alan de Jesús1; Santillán-Doherty, Patricio2,3; Guzmán-Cedillo, Axel Edmundo2; Aguirre-Mariscal, Héctor4; Rivera-Saldana, Rosa Emilia3; Becerra-Aguilar, Francisco3; Cázares-García, Vania5; Martínez-Oñate, Ariel de Jesús3





2021, Number 2

2021; 80 (2)






ABSTRACT

Introduction: Percutaneous tracheostomy is considered to be the gold standard technique for performing tracheostomy in most countries, it is an easy to learn technique and has a minimum of complications, however it is not widely used in Mexico. Objectives: To compare the percutaneous (TPC) and conventional tracheostomy (TC) techniques in a general hospital in Mexico. Material and methods: We performed a retrospective review study of the clinical records of all the patients that underwent a tracheostomy procedur between 1998 and 2014 in a single general hospital in Mexico. All tracheostomy procedures, with both precutaneous and conventional techniques, performed in adults, both female and male, were included. Surgical outcome, mechanical ventilation and hospital stay, were compared between both groups. Results: A hundred and forty patients were included, 94 with TPC and 46 with TC, 56.4 vs 58.7%, respectively. Average age was 64 ± 17 (age ± standard error of mean) and 59 ± 17 years, respectively (p=0.077). Average procedure time was inferior with percutaneous technique, 28 ± 5 vs 48 ± 12 minutes, respectively. Complications with the TPC technique were 19.6%, versus 17% with the TC group (p = 0.815). Hospital stay in the TPC group was 31 ± 5 (mean ± mean standard error), compared to 39 ± 5 days for TC technique (p = 0.038). ICU stay after tracheostomy for the TPC group was 16 ± 5 and 13 ± 3 in the TC technique (p = 0.038). ICU discharge within 30 days after tracheostomy was 94.7% in the TPC group against 82.6% in the TC group (p = 0.030). Conclusions: There is no difference regarding procedural complications between percutaneous tracheostomy technique and conventional tracheostomy, yet, TPC is an accesible, easy to learn and fast technique that holds several advantages; the differences between both techinques in terms of ICU, mechanical ventilation and hospital stay can be attributed to differences related to the different pathologies between both groups.

KEYWORDS

Tracheostomy, percutaneous tracheostomy, dilational tracheostomy, conventional tracheostomy, mechanical ventilation.

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2021, Number 2

2021; 80 (2)