Department of Thoracic Surgery, University of L'Aquila, G Mazzini Hospital, Teramo, Italy.
Surg Today. 2009;39(5):387-92. doi: 10.1007/s00595-008-3899-z. Epub 2009 Apr 30.
To compare the operative technique and complications of the Fantoni tracheostomy (TLT) with those of the Ciaglia Blue Rhino tracheostomy (CBR). We also compared the costs of mini-invasive tracheostomy with those of surgical tracheostomy (ST).
Between January 1998 and January 2006, 530 patients needed emergency intubation and protracted assisted ventilation in our department. We performed 470 mini-invasive tracheostomies: as TLT in 350 and as CBR in 120. The time between intubation and tracheostomy was 4 +/- 1 days. Interventions were carried out in our intensive care unit (ICU).
One hundred and nine patients died within 20 +/- 5 days of intervention, but 361 are still alive after 100 +/- 3 months. TLT and CBR complications were independent of the operative technique (P = 0.74, r = 0.285 vs P = 0.61, r = 0.271) or procedure time (P = 0.95, r = 0.297 vs P = 0.92, r = 0.295). Ciaglia Blue Rhino tracheostomy was noted to have a cost-benefit advantage over TLT and ST (P = 0.0002, P = 0.009, P = 0.22, respectively). The average time until decannulation was 20 +/- 1 days.
Mini-invasive tracheostomies are easy, safe, and fast. Ciaglia Blue Rhino tracheostomy took less time to perform and had fewer complications than TLT, because the technique was simpler.
比较 Fantoni 气管切开术(TLT)与 Ciaglia Blue Rhino 气管切开术(CBR)的手术技术和并发症。我们还比较了微创气管切开术与外科气管切开术(ST)的成本。
1998 年 1 月至 2006 年 1 月期间,我们科室有 530 名患者需要紧急插管和长时间辅助通气。我们进行了 470 例微创气管切开术:350 例采用 TLT,120 例采用 CBR。从插管到气管切开的时间为 4 ± 1 天。干预措施在我们的重症监护病房(ICU)进行。
109 例患者在干预后 20 ± 5 天内死亡,但 361 例患者在 100 ± 3 个月后仍存活。TLT 和 CBR 并发症与手术技术(P = 0.74,r = 0.285 与 P = 0.61,r = 0.271)或手术时间(P = 0.95,r = 0.297 与 P = 0.92,r = 0.295)无关。Ciaglia Blue Rhino 气管切开术在成本效益方面优于 TLT 和 ST(P = 0.0002,P = 0.009,P = 0.22)。拔管平均时间为 20 ± 1 天。
微创气管切开术简单、安全、快速。Ciaglia Blue Rhino 气管切开术比 TLT 操作时间更短,并发症更少,因为技术更简单。