Tracheal Stenosis in Open Versus Percutaneous Tracheostomy.

Area of Science:

• Medical research
• Surgical outcomes
• Pulmonology

Background:

• Tracheostomy is a common procedure to secure an airway.
• Tracheal stenosis is a potential long-term complication following tracheostomy.
• Understanding the comparative risks of different tracheostomy techniques is crucial for patient care.

Purpose of the Study:

• To compare the incidence of tracheal stenosis after open tracheostomy versus percutaneous tracheostomy.
• To evaluate the risk factors associated with tracheal stenosis development post-tracheostomy.

Main Methods:

• Retrospective cohort study of patients undergoing open or percutaneous tracheostomy from January 2017 to June 2023.
• Cox proportional hazard model used to assess differences in tracheal stenosis risk.
• Death was treated as a competing risk to account for patients who died before developing stenosis.

Main Results:

• A total of 828 patients were included; 2.5% developed tracheal stenosis.
• Tracheal stenosis occurred in 3.5% of percutaneous tracheostomy patients and 2.0% of open tracheostomy patients.
• The risk of developing tracheal stenosis was statistically similar between the two techniques (HR: 2.05, p = 0.108).

Conclusions:

• There is no significant difference in the risk of developing tracheal stenosis between open and percutaneous tracheostomy.
• Tracheal stenosis is a long-term complication that does not appear to be influenced by the surgical technique chosen.
• The decision for open versus percutaneous tracheostomy should not be based on the risk of tracheal stenosis.