Evaluation of the effects of three different tracheotomy techniques on tracheal complications and decannulation

Abstract

Objective: Compared to adults, pediatric tracheotomy is associated with a higher incidence of complications. Various surgical techniques have been described to minimize complications. The aim of this study is to investigate the effects of three different tracheotomy techniques on tracheal complications and decannulation.

Methods: Pediatric patients who underwent tracheotomy at Hacettepe University Department of Otorhinolaryngology were retrospectively analyzed. 62 patients were included in the study. Tracheotomy related complications and direct laryngoscopy images of all patients were examined in the postoperative period. The patients were divided into 3 groups according to the tracheotomy technique; vertical incision traction suture (VITS) technique (n: 24), vertical incision maturation suture (VIMS) technique (n: 19), inferior based flap (Björk) technique (BT) (n: 19).

Results: The rate of severe suprastomal pathology was detected as 29.2% in the VITS group, 15.8% in the VIMS group and 26.3% in the BT group (p = 0.656). The accidental decannulation rate was detected as 20.8% in the VİTS group, 26.3% in the VİMS group and 10.5% BT group (p = 0.442). The rate of life-threatening occurrence until recannulated was detected as 60% in the VİTS group, 20% in the VİMS group and 0% in the BT group (p = 0.394). The rate of tracheocutaneous fistula was detected as 13.3% in the VİTS group, 40% in the VİMS group and 33.3% in the BT group (p= 0.337).

Conclusions: There were no differences in complication rates based on techniques, and that stomal complications were common in small children requiring tracheotomies.

Keywords: Complications; Pediatric; Surgical procedures; Tracheal stenosis; Tracheotomy.