Author, year [ref]
Number of studies
Type of included studies
Population
Searching strategy until (years)
Statistical analysis
Number of patients
Main outcome
Conclusions
Dulguerov et al. (1999) [7]
65 articles
RCT, PT, RT
ST vs. PT
1960–1984
1985–1996
No OR, RR or RD calculated
9514
Serious complications: death, cardiopulmonary arrest, pneumothorax, pneumomediastinum, tracheoesophageal fistula, mediastinitis, sepsis, intratracheal postoperative haemorrhage, cannula obstruction and displacement, tracheal stenosis
Intermediate complications: intraoperative desaturation, lesions of the posterior tracheal wall, cannula misplacement, switch of a PT procedure to a surgical technique, aspiration pneumonia, atelectasis, lesion of the tracheal cartilages
Mild complications: intraoperative haemorrhage, false passage, difficulty with tube placement, subcutaneous emphysema, postoperative wound haemorrhage, infections, delayed closure of tracheostomy tract, keloids, unaesthetic scarring
Higher incidence of perioperative complications, perioperative death and serious cardiorespiratory events in the PT group
Higher incidence of postoperative complications in ST group
Freeman et al. (2000) [8]
5 articles
PT
MDT vs. ST
1985–2000
MD; OR
236
Length of procedure; operative complications; intraoperative bleeding; postoperative complications; postoperative bleeding; stoma infection; mortality
PT shorter length and greater ease of procedure
PT lower incidence of overall postoperative complications, intraprocedural and post-procedural bleeding and stoma infections
Delaney. et al. (2006) [9]
17 articles
RCT
PT vs. ST
Inception to 2005
OR
1.212
Wound infection, bleeding, mortality
Compared with ST, PT has a lower incidence of wound infections
Compared with ST, PT is not associated with a higher incidence of clinically significant bleeding, major periprocedural or long-term outcomes
When comparing open ST performed in the ICU, PT has a lower incidence of relevant bleeding
Higgins and Punthake (2007) [10]
368 abstracts;
15 articles
RCT
PT vs. ST
1991–2005
OR
973
Minor haemorrhage; major haemorrhage; false passage; wound infection; unfavourable scar; decannulation/dislodgment; subglottic stenosis; mortality
PT higher incidence of false passage and accidental decannulation
PT lower incidence of wound infection and unfavourable scarring
PT performed faster and with more cost effectiveness
Overall complications did not differ between groups
When comparing open TT performed in the OT vs. PT performed in the ICU, PT has a lower overall complication rate
Cabrini et al. (2012) [17]
13
RCT
Within PT
2000–2010
RD
1130
Conversion to other method; any mild complications; any severe complications
SSDT lower incidence of mild complications than BDT and GWDF
SSDT lower frequency of failure than RDT
GWDF lower incidence of severe complications and frequency of failure than TLT
No differences between MDT and SSDT
MDT lower incidence of mild complications than GWDF, same incidence of severe complications and conversion rate
Putensen et al. (2014) [18]
14
RCT
PT vs. ST; within PT
1966–2013
OR
973
Complications during the procedure: major and minor bleeding, technical difficulties, false route, subcutaneous emphysema, pneumothorax and oxygen desaturation
Complication after the procedure: major and minor bleeding, stoma inflammation or infection, tracheomalacia and tracheal stenosis
PT techniques are performed faster and reduce stoma inflammation and infection
PT are associated with increased technical difficulties when compared with ST
MDT + SSDT are associated with the lowest risk for intraprocedural technical difficulties and major bleeding
GWDF is associated with increased risk for intraprocedural major bleeding
References
1.
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