A comparison of the mechanical strength of two stapled anastomosis techniques for equine small intestine.

The research article compares the durability, construction time, and cost of two stapled methods for connecting segments of a horse’s small intestine. Both methods were found mechanically equivalent, but the functional end-to-end technique proved quicker and cheaper to implement.

Objective of the Study

• The main aim of this study is to compare two methods of performing a jejunojejunostomy, a surgical procedure in which parts of the jejunum (a section of the small intestine) are connected. The two techniques studied are a closed one-stage, stapled functional end-to-end jejunojejunostomy (FEE) and a stapled side-to-side jejunojejunostomy (STS).

Methods Used

• The research was conducted using a randomized block design involving seven adult horses that did not have any gastrointestinal diseases.
• In each horse, the jejunum was isolated and three types of segments were created: Functional end-to-end (FEE), side-to-side (STS) and control segments.
• Data such as the time taken to create the anastomosis (junction between two sections of the intestine), pressure at which the segment failed, mode of failure, length of the failure point etc. were recorded.
• The collected data was used to compare bursting pressure (BP), bursting wall tension (BWT), anastomosis time, and the overall cost of each procedure.

Results

• It was found that the control jejunal segments were mechanically stronger compared to both FEE and STS segments, showing higher resistance to bursting pressure and wall tension.
• No significant difference was found between the mechanical strength of FEE and STS.
• The FEE method was faster to implement and more cost-effective compared to the STS method.

Conclusions

• The study concludes that both FEE and STS techniques are mechanically similar. However, the FEE method, upon maintaining the natural directionality of the segments’ peristalsis (a wave-like motion aiding in the movement of food in the intestine), requires less tissue manipulation and costs less, making it a clinically viable technique.