Sutured End-to-End and Stapled Side-to-Side Jejunal Anastomoses in the Horse



Hand sutured end-to-end (EE) and stapled side-to-side (SS) small intestinal anastomoses were performed in 10 healthy adult horses. In five SS anastomoses, staple lines on the blind ends of the jejunum were inverted (SSI) and in five they were not (SSNI). Five EE anastomoses were sutured with polydioxanone and five were sutured with polyglyconate. All horses were euthanatized on day 30. Intra-abdominal adhesions were graded (0–4), and stomal areas were calculated from contrast radiographs made with the bowel distended. Histopathology scores for the anastomoses were based on the degree of inflammation (0–3), fibrosis (0–3), and alignment and healing of intestinal layers (0–3). Mean surgery times ± standard deviations for EE, SSI, and SSNI techniques were 33.9 ± 5.4, 36.2 ± 5.6, and 29.6 ± 5.9 minutes, respectively. Mean and median stomal areas were 9.4 ± 5.5 and 8.9 cm2 for EE anastomoses and 17.2 ± 16.5 and 12.1 cm2 for SS anastomoses. Intra-abdominal adhesions developed in three horses, one of which had clinical signs of colic. Mean histopathology scores for EE and SS anastomoses were 4.8 ± 2.0 (median = 5) and 4.4 ± 1.8 (median = 4), respectively. There were no statistically significant differences in surgery times, intra-abdominal adhesion scores, stomal areas, or histopathology scores between small intestinal EE and SS anastomoses in these horses.