Pharyngeal tear during gastric calibration tube insertion for laparoscopic sleeve gastrectomy

Arun, Bherya Gopalakrishna; Sanjay, S.

doi:10.4103/1658-354x.177422

Cited by 2 publications

(1 citation statement)

References 3 publications

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“…Insertion of gastric calibration tubes (GCTs) is required during bariatric surgery, especially sleeve gastrectomy, to drain and remove gastric fluid and provide calibration for gastric pouch and leak testing. The complications associated with GCT insertion include pharyngeal and esophageal tears, which increase morbidity and cost in these patients [ 5 , 6 ]. Another important aspect of GCT insertion, which is usually ignored, is the pressure exerted on the trachea, with the resultant increase in cuff pressure of the ETT in situ.…”

Section: Introductionmentioning

confidence: 99%

Endotracheal tube cuff pressure during laparoscopic bariatric surgery: highs and lows

et al. 2022

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Background: Gastric calibration tubes (GCTs) are a unique component of bariatric surgery. This study aimed to assess changes in the endotracheal tube (ETT) cuff pressure during laparoscopic bariatric surgery.Methods: This was a prospective observational study consisting of 124 American Society of Anesthesiologists class I–III morbidly obese patients (body mass index > 40 kg/m2) undergoing elective laparoscopic bariatric surgery under general anesthesia. The baseline ETT cuff pressure was 28 cmH2O. Cuff pressure, peak airway pressure, and hemodynamic changes were observed during various steps of bariatric surgery. Immediate postoperative complications during the first 24 h were recorded. Results: ETT cuff pressure increased signiﬁcantly from the baseline (28 cmH2O) after insertion of GCT (36.3 ± 7.3 cmH2O) and creation of carboperitoneum (33.3 ± 3.8 cmH2O). Cuff pressure decreased significantly on GCT removal (24.0 ± 3.0 cmH2O) and release of carboperitoneum (24.7 ± 3.0 cmH2O). Peak airway pressure increased from the initial baseline value of 25.1 ± 3.1 to 26.5 ± 4.5 after GCT insertion, creation of carboperitoneum (32.6 ± 4.4), attainment of reverse Trendelenburg position (32.3 ± 4.0), and subsequent return to supine position 32.5 ± 4.8.Conclusions: The endotracheal cuff pressure significantly varies during the intraoperative period. Routine monitoring and readjustment of cuff pressure are advisable in all laparoscopic bariatric surgeries to minimize the possibility of postoperative complications.

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Section: Introductionmentioning

confidence: 99%