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A Comparison of the Mechanical Strength of Two Stapled Anastomosis Techniques for Equine Small Intestine

Authors

  • R. Jay Bickers DVM,

    1. From the Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN.
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  • James T. Blackford DVM, MS, Diplomate ACVS,

    1. From the Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN.
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  • Hugo Eiler DVM, PhD,

    1. From the Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN.
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  • Bart Rohrbach VMD, MPH, Diplomate ACVPM

    1. From the Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN.
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  • Presented at the Scientific Poster Session, 35th Annual ACVS Scientific Meeting, September 21–24, 2000, Arlington, VA.

  • Supported by funds from the Tennessee Equine Veterinary Research Organization and the Department of Large Animal Clinical Sciences Resident Research Funds.

  • No reprints available.

James T. Blackford, DVM, MS, Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37901.

Abstract

Objective— To compare bursting strength, time of construction, and cost of a closed one-stage, stapled functional end-to-end jejunojejunostomy (FEE) with a stapled side-to-side jejunojejunostomy (STS).

Study design— Experimental, randomized block design.

Animals— Seven adult horses without gastrointestinal disease.

Methods— The jejunum was isolated, and three FEE, three STS, and three control segments were created in each horse using a randomized block design. Anastomosis time was recorded. The intraluminal pressure at failure and mode of failure were recorded. Length at failure was measured on digitized images. Bursting pressure (BP), bursting wall tension (BWT), anastomosis time, and cost were compared.

Results— Control jejunal segments were stronger (P≤ .0001) in bursting strength and bursting wall tension (P≤ .0001) than either anastomosis type; no difference was found between anastomosis types for either variable. Functional end-to-end jejunojejunostomy was significantly quicker and less costly than STS (P≤ .0001).

Conclusions— Mechanically there were no significant differences between the FEE and STS techniques. The FEE technique maintained the physiologic direction of peristalsis of the segments, required less tissue manipulation, and was faster and more economical to create.

Clinical relevance— The FEE is a clinically viable technique.

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