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Endoscopically monitored percutaneous dilational tracheotomy in a residency program
D R Donaldson1, A J Emami, M K Wax
1Department of Otolaryngology--Head and Neck Surgery, State University of New York at Buffalo, USA.
The Laryngoscope
|July 13, 2000
Summary
Percutaneous dilational tracheotomy (PDT) is a safe and effective airway management technique that can be successfully taught in otolaryngology residency programs. This procedure significantly reduces complications and procedure time compared to traditional open tracheotomy.
Area of Science:
- Otolaryngology
- Surgical Education
- Airway Management
Background:
- Percutaneous dilational tracheotomy (PDT) is an established alternative to open tracheotomy.
- Otolaryngologists' use of PDT is limited, with few residency programs teaching the technique.
Purpose of the Study:
- To determine the complication rate and outcomes of PDT in an otolaryngology residency program.
- To evaluate if reported time savings of PDT can be replicated in a teaching setting.
Main Methods:
- Prospective review of 54 consecutive PDTs.
- Retrospective review of 29 consecutive open tracheotomies.
- Comparison of complication rates, operative time, and total procedure time between PDT and open tracheotomy.
Main Results:
- PDT group had significantly lower complication rates (13% vs. 33%, P = .030).
- PDT significantly reduced operative time (12 vs. 24 min, P < .0001) and total procedure time (37 vs. 80 min, P < .001).
- Initial outcomes were comparable between PDT and open tracheotomy groups.
Conclusions:
- PDT can be safely and effectively taught within an otolaryngology residency training program.
- PDT offers significant advantages in terms of reduced complications and procedure time.