Combination of end-to-end jejuno-ileal anastomosis and side-to-side incomplete ileocecal bypass (hybrid jejuno-ileo-cecal anastomosis) following subtotal ileal resection in seven horses.

The research article discusses the implementation and outcomes of a surgical procedure, known as the hybrid jejuno-ileo-cecal anastomosis, performed on 7 horses that were experiencing severe colic due to small intestine obstruction.

Objective and Methodology

• The study focuses on 7 horses that were brought for examination due to acute colic caused by small intestinal obstruction.
• The obstruction was located in the aborad part of their jejunum and orad portion of the ileum – parts of the small intestine.
• All the horses had been diagnosed with strangulating obstruction of the small intestine, which creates a life-threatening situation and necessitates immediate intervention.
• The horses underwent an emergency exploratory laparotomy – a surgical operation where the abdomen is opened and examined for pathology.
• During the operation, the affected parts of the intestine were resected and a hybrid jejuno-ileo-cecal anastomosis procedure was performed. “Anastomosis” refers to the surgical connection of two parts.

Surgical Procedure

• The surgical procedure, hybrid jejuno-ileo-cecal anastomosis, involved connecting the jejunum (the part of the small intestine between the duodenum and ileum) directly to the ileum (the final section of the small intestine), bypassing the damaged part of the ileum. This procedure was performed to restore continuity in the small intestine.
• In 5 of the horses, the connection between the jejunum and ilium was created with a hand-sewn method while an incomplete ileocecal bypass was also created, forming the hybrid anastomosis.
• For the remaining 2 horses, half the anastomosis was sewn by hand while the other half was stapled, and again combined with an incomplete ileocecal bypass.

Results

• All horses survived the operation and were discharged from the hospital. They did not show any signs of colic or ileus (the disruption of the intestine’s ability to contract and propel their contents) during the postoperative period.
• Longer-term, 6 horses were found to be living without signs of recurring colic 4 to 17 months after surgery.
• However, 1 horse had to be euthanized 17 months after the surgery due to colic.
• The results suggested that this hybrid surgical technique could be a viable option for treating small intestinal obstructions in horses, specifically those involving the orad portion of the ileum.
• However, more research is needed to understand the short-term and long-term effects of this procedure.