A CLINICAL AND HISTOLOGIC COMPARISON OF PERCUTANEOUS DILATIONAL VERSUS CONVENTIONAL SURGICAL TRACHEOSTOMY

To directly compare percutaneous dilational tracheostomy (PDT) with co nventional surgical tracheostomy, a prospective study was performed in 83 patients requiring tracheostomy for prolonged mechanical ventilati on in the intensive care unit or after surgery for a large tumor in th e upper respiro-digestive tract, Median follow-up was 355 days after P DT and 338 days after conventional tracheostomy. The overall morbidity rate was significantly lower with PDT than with conventional tracheos tomy (6.4% vs 36.1%; P < 0.001). Compared with conventional tracheosto my, PDT was also associated with a significantly lower incidence of po stoperative bleeding (2.1% vs 13.9%; P < 0.05) and postoperative wound infection (0% vs 22.2%; P < 0.001). There were no clinical signs of l aryngotracheal stenosis in either group, In conclusion, PDT is a simpl e, fast, safe bedside procedure that is associated with significantly lower morbidity than standard surgical tracheostomy.