ObjectiveTo observe the differences and similarities of complications between percutaneous tracheotomy and traditional tracheotomy and to analyze the reasons.MethodsA prospective study was conducted to 200 neurosurgical patients who needed tracheotomy. They were randomly and equally divided into percutaneous tracheotomy group and traditional tracheotomy group. The data on postoperative complications in both groups were calculated within two weeks after surgery.ResultsComplications occurred in 19 cases of the percutaneous tracheotomy group, including postoperative hemorrhage in 15, subcutaneous emphysema in 2, and incision infection in 2. As for the traditional tracheotomy group, the complications occurred in 8 cases, including hemorrhage in 4, subcutaneous emphysema in 3, and incision infection in one. Statistical analyses showed significant difference of postoperative hemorrhage (P<0.05), and insignificant differences of subcutaneous emphysema and incision infection between the two groups (both P>0.05). The analyses also revealed that the difference of complication rate between both groups was statistically significant (P<0.05).ConclusionsThe risk of early postoperative complications of percutaneous tracheotomy was higher than that of traditional tracheotomy in neurosurgical patients. For the patients who need urgent tracheotomy, percutaneous tracheotomy is preferable. Otherwise, traditional tracheotomy is preferred, particularly for obese ones with short neck or relatively stable condition.