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Comparison of One-Layer (Continuous Lembert) Versus Two-Layer (Simple Continuous/Cushing) Hand-Sewn End-to-End Anastomosis in Equine Jejunum

Authors

  • JORGE E. NIETO DVM, PhD, Diplomate ACVS,

    1. From the Department of Surgical and Radiological Sciences Comparative Gastroenterology Laboratory, School of Veterinary Medicine, University of California – Davis, Davis, CA.
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  • JULIE E. DECHANT DVM, MS, Diplomate ACVS,

    1. From the Department of Surgical and Radiological Sciences Comparative Gastroenterology Laboratory, School of Veterinary Medicine, University of California – Davis, Davis, CA.
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  • JACK R. SNYDER DVM, PhD, Diplomate ACVS

    1. From the Department of Surgical and Radiological Sciences Comparative Gastroenterology Laboratory, School of Veterinary Medicine, University of California – Davis, Davis, CA.
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  • This work was supported by contributions of private donors to the Comparative Gastrointestinal Laboratory. Presented in part at the 8th International Equine Colic Research Symposium, Quebec City, Canada, August 3–5, 2005.

Address reprint requests to Dr. Jorge Nieto, DVM, PhD, Diplomate ACVS, Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California––Davis, One Shields Avenue, Davis, CA 95616. E-mail: jenieto@ucdavis.edu.

Abstract

Objective— To evaluate single and double layer end-to-end anastomosis in equine jejunum.

Study Design— Experimental in vitro study.

Animals— Mid-jejunal sections from 12 adult horses without gastrointestinal disease.

Methods— Jejunal end-to-end anastomoses were performed by a continuous Lembert pattern or a simple continuous pattern oversewn with a Cushing pattern. Jejunal segments were distended with fluid at 1 L/min, and intraluminal pressure at failure, and mode of failure were recorded. Bursting pressure and bursting wall tension were calculated. Anastomosis construction time and degree of luminal reduction were recorded.

Results— Single layer anastomoses were constructed in less time than 2-layer anastomoses. Both anastomotic techniques resulted in luminal reduction compared with control tissue; however, the reduction was smaller with a 1-layer continuous Lembert anastomosis. No differences were noted in bursting pressure or bursting wall tension between groups.

Conclusions— Anastomosis using a 1-layer continuous Lembert pattern resulted in a larger stoma, was faster to perform, and as strong as a 2-layer anastomosis.

Clinical Relevance— Use of a 1-layer continuous Lembert pattern for jejunojejunosotomy may be beneficial by decreasing anastomosis time and produce a larger stoma than a 2-layer anastomosis.

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