Molardi Alberto, Benassi Filippo, Manca Tullio, Ramelli Andrea, Vezzani Antonella, Nicolini Francesco, Romano Giorgio, Ricci Matteo, Carino Davide, Di Chicco Maria Vincenza, Gherli Tiziano
Department of General and Specialistic Surgery, Section of Cardiac Surgery, Parma University Hospital, Parma, Italy.
Department of General and Specialistic Surgery, Section of Cardiac Surgery Intensive Care, Parma University Hospital, Parma, Italy.
J Thorac Dis. 2016 Dec;8(12):3633-3638. doi: 10.21037/jtd.2016.12.100.
The aim of our study is to compare the classical surgical tracheostomy (TT) technique with a modified surgical technique designed and created by the cardiothoracic surgery staff of our department to reduce surgical trauma and postoperative complications. This modified technique combines features of percutaneous TT and surgical TT avoiding the use of specialized tools, which are required in percutaneous TT.
From October 2008 to March 2014 we performed 67 tracheostomies using this New Modified Surgical Technique (NMST) and 56 TT with the Classical Surgical Technique (CST). We collected data about the early clinical complications, deaths TT-related, deaths due to other complications and the presence of late TT's complications were performed by a telephone follow-up. SPSS software (IMB version 21) was used for the statistical analysis. Categorical data were treated with chi-square test and continuous data were treated with -test for independent samples.
NMST group had a significant lower number of early complications (P=0.005) compared to CST group (5 . 15). In-hospital mortality was significantly higher in CST group (18 deaths . 4 in NMST group, P=0.001) but we registered only one case of TT-related mortality in CST group (P=0.280). We did not note other differences between the two groups regarding short or mid-long term complications.
In our experience the NMST demonstrated to be easily safe and reproducible with an amount of early, mid- and long-term complications similar to the CST; furthermore the aesthetic results of the procedure appear similar to those of percutaneous TT.
我们研究的目的是将经典外科气管切开术（TT）技术与由我们科室心胸外科工作人员设计并创造的改良外科技术进行比较，以减少手术创伤和术后并发症。这种改良技术结合了经皮气管切开术和外科气管切开术的特点，避免了经皮气管切开术所需的专用工具的使用。
从2008年10月至2014年3月，我们使用这种新改良外科技术（NMST）进行了67例气管切开术，使用经典外科技术（CST）进行了56例气管切开术。我们收集了早期临床并发症、与气管切开术相关的死亡、其他并发症导致的死亡以及晚期气管切开术并发症的数据，通过电话随访进行。使用SPSS软件（IBM版本21）进行统计分析。分类数据采用卡方检验，连续数据采用独立样本t检验。
与CST组（5例. 15例）相比，NMST组早期并发症数量显著更低（P = 0.005）。CST组的院内死亡率显著更高（18例死亡. NMST组4例，P = 0.001），但我们在CST组仅记录到1例与气管切开术相关的死亡（P = 0.280）。在短期或中长期并发症方面，我们未注意到两组之间的其他差异。
根据我们的经验，NMST证明易于操作、安全且可重复，其早期、中期和长期并发症的数量与CST相似；此外，该手术的美学效果似乎与经皮气管切开术相似。
