Five studies including three RCTs, one quasi-RCT and one study whose method of treatment allocation was unknown were included (236 patients in total, 115 PDT and 121 SCT).
All operative complications (n=3 studies) OR=0.73 (95% CI: 0.06, 9.73).
Operative bleeding (n=3 studies) OR=0.15 (95% CI: 0.02, 0.39) in favour of PDT.
All postoperative complications (n=5 studies) OR=0.15 (95% CI: 0.07, 0.29) in favour of PDT.
Postoperative bleeding (n=5 studies) OR=0.39 (95% CI: 0.18, 0.88) in favour of PDT.
Stomal infections (n=5 studies) OR=0.02 (95% CI: 0.01, 0.07) in favour of PDT.
Death (n=5 studies) OR=0.63 (95% CI: 0.18, 2.20).
Overall procedure-related complications (n=3 studies) OR=0.73 (95% CI: 0.06, 9.37).
Days intubated prior to tracheostomy (n=5 studies) absolute difference=0.16 days (95% CI: -0.9, 1.22) in favour of SCT.
Operative time (n=4 studies) absolute difference=9.84mins (95% CI: 7.83, 11.85) in favour of PDT.
The studies were homogeneous. Four stated the method of randomisation used, none included a power calculation and only three of the studies verified the seriousness of the patients' illness. All of the studies used the same dilational technique described by Ciaglia and standard methods of creating a surgical tracheostomy.