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The guide wire dilating forceps technique of percutaneous tracheostomy
N van Heerbeek1, B G Fikkers, F J van den Hoogen
1Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Nijmegen, The Netherlands.
American Journal of Surgery
|May 18, 1999
Summary
The guide wire dilating forceps (GWDF) technique for percutaneous tracheostomy is safe and effective, with a 98% success rate. Fiberscopic control enhances safety, making it a viable bedside alternative to open tracheostomy.
Area of Science:
- Medical Procedures
- Surgical Techniques
- Critical Care Medicine
Background:
- Prospective evaluation of the percutaneous tracheostomy using the guide wire dilating forceps (GWDF) technique.
- Assessment of the GWDF technique as a bedside procedure.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous tracheostomy performed with the GWDF technique.
- To determine the complication rates associated with the GWDF technique.
Main Methods:
- Percutaneous tracheostomy was performed in 50 selected patients using the GWDF technique.
- Fiberscopic control was utilized throughout the procedure for monitoring.
- Patient outcomes and complications were prospectively evaluated.
Main Results:
- The GWDF technique demonstrated a high success rate of 98% (49 out of 50 patients).
- No life-threatening complications or deaths were reported. Perioperative complications occurred in 10% of patients (5/50), with one significant bleeding event requiring conversion to open tracheostomy.
- Early complications were observed in 13% of patients (6/48), and late subglottic stenosis occurred in 6% of successfully decannulated patients (2/36).
Conclusions:
- The GWDF technique is a safe and efficient bedside alternative to open tracheostomy.
- Fiberscopic control is recommended to enhance procedural safety.
- Percutaneous tracheostomy using the GWDF technique is justifiable for patients requiring tracheostomy, though further studies on late complications are warranted.