Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Tracheostomy has become the method of choice in managing patients requiring long-term mechanical ventilation. At present, there are several alternatives to conventional surgical tracheostomy such as percutaneous dilatational techniques according to Ciaglia, Frova, and Fantoni. The basic principle of these new techniques is percutaneous puncture of the trachea and subsequent dilatation of the puncture channel until the tracheal cannula can be inserted. ⋯ Some significant complications and contraindications have been recognized recently. This should be taken into account when planning tracheostomy in long-term ventilated patients. Compared to conventional surgical tracheostomy, this new procedure retains its value and benefit only if these contraindications are carefully observed.