Abstract
Objective:We aimed to clarify the safety of open surgical tracheotomy performed by supervised residents, and the impact of “reason for hospitalization” on complication rates in open surgical tracheotomy technique.Methods:In this retrospective cohort study, the medical files and documents of 277 patients who underwent open surgical tracheotomy (OST) over a period of 12 years from October 2005 to July 2017 were analyzed. Forty four patients were excluded due to emergent tracheotomy and presence of malignancy. Remaining 223 cases were divided into two groups as “OSTs done by supervised residents” and “OSTs done by attending surgeons”. Age, gender, reason for hospitalization, observation time and complications were noted. The overall minor and major complication rates and each complication rate were compared with regard to the operating surgeons.Results:No statistically significant difference between two groups was demonstrated in terms of observation time (p=0.127). Minor complication rate for residents and attending surgeons was 14.7% and 17.5%, whereas major complication rate was 6.3% and 5.0%, respectively. No significant difference was found between two groups both in terms of minor (p=0.58) and major (p=0.43) complication rates. No risk of “reason for hospitalization” on minor and major complications was found (p=0.06, p=0.15).Conclusion:Open surgical tracheotomy performed by supervised residents is as safer as the ones performed by the attending surgeons. The study also showed that “reason for hospitalization” does not potentiate the occurrence of tracheotomy related complications.
Highlights
Open Surgical Tracheotomy (OST) has long been used mainly for securing upper airway
We aimed to find out if there is any difference between OSTs performed by supervised residents and attending surgeons in terms of minor and major complication rates, which is not studied before
We evaluated the effect of Reason for Hospitalization (RfH) on complication rates
Summary
Open Surgical Tracheotomy (OST) has long been used mainly for securing upper airway. The term “tracheotomy” was first used in 1739 by Lorenz Heister, it dates back to 2000 BC.[1] Currently, two main indications for tracheotomy are Upper Airway Compromise (UAC) and Prolonged Intubation (PI).[2] In the first half of the 20th century, tracheotomies performed due to UAC were far more frequent with indications of infections such as diphtheria, acute supraglottitis and deep neck abscesses. PI recently gets ahead because of novel preventive measures for infectious diseases and widespread use of mechanical ventilation.[3]. OST is known as a relatively safe procedure and it is one of the initial interventions learned
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