Closed one-stage functional end-to-end jejunojejunostomy in horses with use of linear stapling equipment.

This study investigates the application of gastrointestinal linear stapling equipment in performing a closed, one-stage jejunojejunostomy in adult horses, introducing it as an alternative to the traditional side-to-side stapling method. The study assessed the clinical outcomes, anatomic structures, histological findings and dimensions of the anastomosis as part of a detailed evaluation of the procedure’s effectiveness and suitability.

Methodology

• The study involved 18 adult horses on which the one-stage functional end-to-end jejunojejunostomy was performed using the linear stapling equipment.
• Postoperative examinations were carried out at different intervals: 2, 4, 8, 16, and 24 weeks. During these sessions, anatomic and histological architecture, and anastomotic dimensions were analyzed.
• The researchers focused on inspecting the anastomosis and the peritoneal cavity for any adhesions. They calculated the diameter and circumference of the anastomosis and jejunum’s oral and aboral sections using digitized contrast radiographs and linear measurements.
• The healing of the anastomotic site was evaluated histologically to assess the tissue healing and monitor any complications.

Results

• Three horses were euthanized in the immediate postoperative period. For the 15 remaining horses, no peritoneal adhesions or distortion of the anastomoses were observed, indicating the procedure had been successful.
• The stomas reshaped into an end-to-end structure. The mean diameter of the anastomotic staple line (7.48 cm) and mucosa (6.89 cm) were significantly larger than the mean jejunal oral (6.03 cm) and aboral (6.01 cm) diameters. The mean anastomotic luminal circumference (13.61 cm) was considerably larger than the oral (11.43 cm) and aboral (11.12 cm) jejunal circumference.
• From a histologic perspective, there was appropriate mucosal and muscularis mucosae reapposition, marked by an average degree of fibrosis and inflammation. These findings endorse the effectiveness of the stapling device and system.

Conclusions

• The results demonstrate that the closed, one-stage functional end-to-end jejunojejunostomy technique can result in a functional anastomosis and hence, can be considered a viable procedure option.
• This newfound technique, performed using linear stapling, is suggested to be a practical alternative to conventional side-to-side jejunojejunostomies in horses.