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Veterinary surgery : VS2025; doi: 10.1111/vsu.14294

An ex vivo comparison of jejunal transection angles and the effect on lumen diameter following end-to-end jejunojejunal anastomoses.

Abstract: To evaluate three different jejunal transection angles for end-to-end jejunojejunostomies, comparing construction time, lumen size, and suture number. Methods: Ex vivo cadaver study. Methods: Eight euthanized horses each had three mid-jejunal specimens harvested. Methods: Jejunal segments were assigned to one of three groups (A30, A45, and A60) and transected at 30, 45, or 60°, respectively. Following transection, a standardized handsewn single-layer interrupted modified Lembert anastomosis was performed, and construction time and number of sutures placed were recorded. Anastomotic index (AI) was calculated. Statistical analysis was performed using a one-way ANOVA. Statistical significance was set at p < .05. Results: Transected jejunal lengths increased as the transection angle decreased (p  .333). Mean AI were 93.37, 114.29, and 135.07 for groups A60, A45, and A30 and the AI increased as the transection angle decreased (p < .001). Conclusions: A 60° transection angle reduced lumen size at the anastomosis but a 45 and 30° transection angle resulted in an increased lumen size at the anastomosis. The 45° angle did not increase the number of sutures required. The 30° angle significantly increased the number of sutures required. Conclusions: A 45° angle of transection does not result in increased surgical time or number of sutures placed. Further investigation is required to determine the ideal angle of transection.
© 2025 The Author(s). Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
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Publication Date: 2025-06-17 PubMed ID: 40525474DOI: 10.1111/vsu.14294Google Scholar: Lookup
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Summary

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This study investigates the impact of different transection angles on the diameter of the jejunal lumen in horses, also assessing factors like construction time and the number of sutures required. It concluded that a 45° transection angle does not lead to increased surgical time or the number of sutures, while enhancing the lumen size.

Research Methodology

  • The study was carried out ex vivo, meaning it was performed outside a living organism, using specimens of the equine jejunum segments harvested from euthanized horses.
  • These jejunal segments were divided into three groups for the experiment. Each group represents a different transection angle – 30 degrees (A30), 45 degrees (A45), and 60 degrees (A60).
  • After the transection at the respective angles, a standard hand-sewn single-layer interrupted modified Lembert anastomosis was performed. An anastomosis is the surgical connection of separate or severed channels such as blood vessels or loops of the intestine.
  • Construction time and the number of sutures applied were then recorded. The researchers also calculated the Anastomotic index (AI), a measure used to reflect the quality and efficacy of an anastomosis.
  • Statistical analysis of the data gathered was done using one-way ANOVA, with statistical significance set at p < .05.

Research Findings

  • The research found that as the transection angle decreased, transected jejunal lengths increased significantly (p < .001).
  • However, the time taken to construct the anastomoses showed no significant variation among the different groups.
  • The number of sutures required to complete the anastomosis was higher for the A30 group as compared to the A60 group, but there was no notable difference between A60 and A45 or A45 and A30.
  • The Anastomotic index also increased notably as the transection angle decreased.

Conclusions and Implications

  • The study concluded that a 60° transection angle reduced the lumen size at the anastomosis, while a 45° and 30° transection angles resulted in an increased lumen size at the anastomosis.
  • A significant finding was that the 45° transection angle did not increase the number of sutures required or the surgical time, but increased lumen size, making it a potentially relevant technique in such surgeries.
  • The researchers emphasized that further investigation is necessary to conclusively establish the ideal transection angle.

Cite This Article

APA
Baldwin CM, Gillen A. (2025). An ex vivo comparison of jejunal transection angles and the effect on lumen diameter following end-to-end jejunojejunal anastomoses. Vet Surg. https://doi.org/10.1111/vsu.14294

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English

Researcher Affiliations

Baldwin, Christopher M
  • Department of Equine Clinical Science, Institute of Veterinary Science, University of Liverpool, Leahurst Campus, Neston, UK.
Gillen, Alexandra
  • Department of Equine Clinical Science, Institute of Veterinary Science, University of Liverpool, Leahurst Campus, Neston, UK.

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