Sanji Rajiv Ranganath, Channegowda Chandrakiran, Patil Sanjay B
Department of ENT, M S Ramaiah Medical College, MSR Nagar, MSRIT Post, Bangalore, 560054 India.
Indian J Otolaryngol Head Neck Surg. 2017 Mar;69(1):11-15. doi: 10.1007/s12070-016-0983-3. Epub 2016 May 10.
Minimally invasive techniques were used for tracheostomy including small horizontal skin incision, limited soft tissue dissection and no suturing. A Retrospective analysis of case sheets of patients who underwent elective tracheostomy by the first and second authors at M S Ramaiah Hospitals in Bangalore between 1st May 2010 and 1st May 2015 was done to compare the result of elective conventional open surgical tracheostomy using midline vertical skin incision with minimally invasive tracheostomy using a short horizontal incision. No statistically significant difference in the peri and post operative complication rate was found. The patterns of intra and post operative complications reflected the choice of the surgical technique-the conventional technique had problems associated with wide dissection, whereas the minimally invasive technique had problems associated with limited exposure. Problems of wound gaping, emphysema and peristomal inflammation were reduced with minimally invasive technique with short horizontal skin incision although statistical difference could not be shown. There was also no statistically significant difference with either technique regards death and decannulation rates. Minimally invasive technique of elective open surgical tracheostomy was found to be as safe as conventional open surgical tracheostomy with midline vertical skin incision in the studied groups.
采用微创技术进行气管切开术，包括小的水平皮肤切口、有限的软组织分离且不缝合。对2010年5月1日至2015年5月1日期间在班加罗尔的M S Ramaiah医院由第一和第二作者进行择期气管切开术的患者病历进行回顾性分析，以比较采用中线垂直皮肤切口的择期传统开放性手术气管切开术与采用短水平切口的微创气管切开术的结果。结果发现围手术期和术后并发症发生率无统计学显著差异。手术中和术后并发症的模式反映了手术技术的选择——传统技术存在与广泛分离相关的问题，而微创技术存在与暴露受限相关的问题。采用短水平皮肤切口的微创技术可减少伤口裂开、气肿和造口周围炎症等问题，尽管未显示出统计学差异。两种技术在死亡率和拔管率方面也无统计学显著差异。在研究组中，发现择期开放性手术气管切开术的微创技术与采用中线垂直皮肤切口的传统开放性手术气管切开术一样安全。
