title: [Changes in the distance between carina and orotracheal tube during open or videolaparoscopic bariatric surgery].
abstract: OBJECTIVE
  To examine whether there are changes in the distance between the orotracheal tubeand carina induced by orthostatic retractor placement or by pneumoperitoneum insufflation in obese patients undergoing gastroplasty.
  
  
  METHODS
  60 patients undergoing bariatric surgery by two techniques: open (G1) or videola-paroscopic (G2) gastroplasty were studied. After tracheal intubation, adequate ventilation of both hemitoraxes was confirmed by lung auscultation. The distance orotracheal tube-carina was estimated with the use of a fiber bronchoscope before and after installation of orthostatic retractors in G1 or before and after insufflation of pneumoperitoneum in patients in G2.
  
  
  RESULTS
  G1 was composed of 22 and G2 of 38 patients. No cases of endobronchial intubationwere detected in either group. The mean orotracheal tube-carina distance variation was estimated in -0.03 cm (95% CI 0.06 to -0.13) in the group of patients undergoing open gastroplastyand in -0.42 cm (95% CI -0.56 to -1.4) in the group of patients undergoing videolaparoscopic gastroplasty. The extremes of variation in each group were: 0.5 cm to -1.6 cm in patients under-going open surgery and 0.1 cm to -2.2 cm in patients undergoing videolaparoscopic surgery.
  
  
  CONCLUSIONS
  There was no significant change in orotracheal tube-CA distance after placementof orthostatic retractors in patients undergoing open gastroplasty. There was a reduction inorotracheal tube-CA distance after insufflation of pneumoperitoneum in patients undergoing videolaparoscopic gastroplasty. We recommend attention to lung auscultation and to signals of ventilation monitoring and reevaluation of orotracheal tube placement after peritoneal insufflation.
authors.affiliation: Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brasil. Electronic address: giovanilocks@gmail.com.
authors.forename: Giovani
authors.initials: G
authors.lastname: de Figueiredo Locks
authors.affiliation: Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brasil.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Simões de Almeida
authors.affiliation: Ultralitho Centro Médico, Florianópolis, SC, Brasil.
authors.forename: Maurício
authors.initials: M
authors.lastname: Sperotto Ceccon
authors.affiliation: Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brasil.
authors.forename: Karen Adriana
authors.initials: KA
authors.lastname: Campos Pastório
keywords: Bariatric surgery; Cirurgia bariátrica; Endotracheal intuba‐tion/complications; Intubação intratraqueal/Complicações; Laparotomia; Laparotomy; Obesidade; Obesity; Pneumoperitoneum; Pneumoperitônio