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Tracheostomy—The horizontal tracheal incision

  • I. Kato (a1), K. Uesugi (a1), M. Kikuchihara (a1), H. Iwasawa (a1), J. Iida (a1), K. Tsutsumi (a1), H. Iwatake (a1) and I. Takeyama (a1)...

Abstract

The complication rate after emergency tracheostomy is two to five times greater than after elective procedures. One of the main causes of the high risk of complications in emergency tracheostomy appears to be the amount of time required to open the trachea. Therefore, simple and fast procedures are mandatory. We have developed a new procedure as follows: A horizontal skin incision is performed. Strap muscles are dissected and retracted laterally. A transverse cut between tracheal rings below the thyroid isthmus is performed up to membranous portion of the trachea. The cut ends of the trachea remain open naturally because of the elasticity of the trachea. Skin and tracheal cut-ends are then joined by interrupted sutures.

We have used this procedure during the past three years and have not experienced any major complications. This demonstrates the clear advantage and the more physiological nature of the procedure over various other incisions of the tracheal wall.

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Corresponding author

Dr. I. Kato, Department of Otolaryngology, St. Marianna University School of Medicine, Miyamae, Sugao 2-16-1, 213 Kawasaki, Kanagawa, Japan

Footnotes

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Paper presented by Dr. K. Uesugi at the 6th World Congress of Bronchoesophagology in Tokyo 15-18 October 1989.

Footnotes

References

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Andrews, M. J., Pearson, F. G. (1971) Incidence and pathogenesis of tracheal injury following cuffed tube tracheostomy with assisted ventilation: Analysis of a two-year prospective study. Annals of Surgery, 173: 249263.
Davis, H. S., Kretchmer, H. E. (1953) Advantages and complications of tracheotomy. Journal of American Medical Association, 153: 11561159.
Eiseman, B., Spencer, F. C. (1963) Tracheostomy: An underrated surgical procedure. Journal of American Medical Association, 184: 684687.
Eliacher, I., Goldsher, M., Joachims, H. Z. (1981) Superiorly based tracheostomal flap to counteract treacheal stenosis: Experimental study. Laryngoscope, 91: 976981.
Harley, HR. S. (1971) Laryngotracheal obstruction complicating tracheostomy or endotracheal intubation with assisted respiration. Thorax, 26: 493533.
Hughes, M., Kirchner, J. A., Branson, R. J. (1971) A skinlined tube as a complication of tracheostomy. Archives of Otolaryngology, 94: 568570.
Lulenski, G. C., Batsakis, J. G. (1979) Management of the flap tracheostomy. Archives of Otolaryngology, 105: 260263.
Paloschi, G., Lynn, R. B. (1965) Observations upon elective and emergency tracheostomy. Surgery, Gynecology and Obstetrics, 120: 356358.
Potondi, A. (1969) Pathomechanism of hemorrahages following treachotomy. Journl of Laryngology and Otology, 83: 475484.
Rogers, L. A. (1969) Complications of tracheostomy. Southern Medical Journal, 62: 14961500.
Sasaki, C. T., Horiuchi, M., Koss, N. (1979) Tracheostomy-related subglottic stenosis: Bacteriologic pathogenesis. Laryngoscope, 89: 857865.
Stiles, P. J. (1965) Tracheal lesions after tracheostomy. Thorax, 20: 517522.

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