A fast method of surgical tracheostomy: A preliminary result of minimally invasive tracheostomy

Abstract

Kuang-Hwa Cheng, Chih-Hao Chen, Chang Ho, Chao-Hung Chen, Hung-Chang Liu, Tzu-Ti Hung

Introduction: Currently, the percutaneous puncture method is a popular method for performing tracheostomies. However, unexpected bleeding or organ injury is a concern with this method because the dissection or dilatation is blind. A conventional open surgical tracheostomy (COST) usually takes more time to complete, but the procedure has a lower risk of bleeding compared to blind method used in the percutaneous puncture approach. In this study, we evaluated a fast open surgical tracheostomy (FOST) procedure, which combines the advantages of both open and percutaneous methods. Materials and Methods: From January 1, 2009, to December 31, 2010, our team performed surgeries on 259 patients in our institution that were indicated for tracheostomy. During this period, both COST and FOST methods were performed. These patients were not randomized with regard to method. No additional or specialized tools are required in the FOST method. All operations were performed by a single surgeon. The operative details and outcomes were analyzed. Results: One hundred and fifty-six patients underwent COST, while 103 patients underwent FOST. There was no difference in gender distribution, age and indications for surgery in either group. The operative time was much faster in FOST than in COST. There was no acute or delayed bleeding in either group. Minor stoma infection was seen in five patients in the FOST group and 12 patients in the COST group. Conclusion: The FOST provided a faster alternative to COST, while preserving the techniques of open dissection and resulting in comparable outcomes