RESUMO
Objectives: The main objectives of this study were to evaluate the complications of tracheostomy in IDPs patients who were admitted in DHQ teaching hospital Bannu and further the study of complications in relation with tracheostomy types, age and tracheostomy tubes types
Study Design: Observational / analytic / cross sectional study
Place and Duration of Study: The study was conducted at the ENT Unit, DHQ Teaching Hospital, Bannu from April 2015 to December 2015
Materials and Methods: 60 patients undergoing tracheostomy, having an age group of 3 to 65 and fulfilling inclusion and exclusion criteria were selected. Elective and emergency tracheostomy was included in the study period. "Open surgical technique" was done. Metallic and portex cuffed rubber tubes ware used. To record any possible complication, a pre-designed proforma was used
Results: The study comprised 42 males and 18 females. The mean age of the patients was 30 years[SD+18.20]. Elective tracheostomy was done in 10% while emergency tracheostomy was done in rest of the 90% patients. Metallic tubes were used in 20% and portex cuffed rubber tubes in 80% of the patients. The recorded complication rate was 40% overall. There was an 18% immediate, 11% intermediate and 11% late complications. Complication rate was somewhat elevated in early age. Bleeding was commonest complication [20%] among all followed by emphysema, dysphagia and aspiration [4% each]. Complication rate of emergency tracheostomy was higher than elective one. Similarly, complication rate with portex cuffed rubber tubes was greater than metallic tubes
Conclusion: Rate of complication in emergency tracheostomy was higher than elective tracheostomy where as in elder patients; it was lower than in younger patients. Similarly, complication rate was greater with portex cuffed rubber tubes. From the study, it is concluded that post op care can minimize the chances of post tracheostomy complications
RESUMO
To compare the conventional method of tonsillectomy, the dissection snare method with that of the newer procedure, bipolar electrodissection method. We studied 200 cases in two groups, hundred in each. In the first group the patients underwent tonsillectomy by dissection-snare method and in the second by electrodissection method. The results of the two groups were studied regarding the time taken in the procedure, blood loss during the procedure, postoperative analgesia required, reactionary hemorrhage, postoperative diet toleration and secondary hemorrhage. The average operation time was 14.2 minutes for diathermy group and 35 minutes for the dissection-snare group. Regarding the postoperative diet taken and reactionary heamorrhage the bipolar diathermy method is better, but there is no significant difference regarding the postoperative analgesia, postoperative pain and secondary hemorrhage. We concluded that bipolar electrodissection [diathermy] method is the superior method regarding the time taken during the procedure, the intra operative blood loss was lower and there was no need of ties [ligating the bleeding vessels] in the diathermy method