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Home / Equine Research Bank / Vet Surg / Comparison of one-layer (continuous Lembert) versus two-laye...
Veterinary surgery : VS2006; 35(7); 669-673; doi: 10.1111/j.1532-950X.2006.00206.x

Comparison of one-layer (continuous Lembert) versus two-layer (simple continuous/Cushing) hand-sewn end-to-end anastomosis in equine jejunum.

Abstract: To evaluate single and double layer end-to-end anastomosis in equine jejunum. Methods: Experimental in vitro study. Methods: 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. Conclusions: 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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Publication Date: 2006-10-10 PubMed ID: 17026553DOI: 10.1111/j.1532-950X.2006.00206.xGoogle Scholar: Lookup
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  • Comparative Study
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This study evaluates and compares the effectiveness of one-layer and two-layer surgical procedures used in repairing the equine jejunum, concluding that a one-layer process is more efficient and equally as secure as the two-layer method.

Methodology

  • The research was carried out experimentally in vitro using the mid-jejunal sections of 12 adult horses that did not have gastrointestinal diseases.
  • End-to-end anastomosis was performed with either a one-layer continuous Lembert-pattern technique or a two-layer continuous technique employing a simple continuous pattern that was then oversewn with a Cushing pattern.
  • To assess the effectiveness of these techniques, the jejunal segments were distended with fluid at a rate of 1 liter per minute, and then the intraluminal pressure at failure and mode of failure were recorded.
  • The researchers also calculated the bursting pressure and bursting wall tension, and took note of anastomosis construction time and degree of luminal reduction.

Findings

  • Single-layer anastomoses were done more quickly than two-layer ones.
  • Both types of anastomoses resulted in a reduction in luminal size compared to the control sample, but the reduction was less in the single-layer technique.
  • No significant differences were noted in bursting pressure or bursting wall tension among the two groups, indicating that the strength of the anastomosis was similar for both techniques.

Conclusion

  • Anastomosis with a single-layer continuous Lembert pattern resulted in a larger stoma, took less time to perform, and was as secure as the two-layer anastomosis.
  • Using a single-layer continuous Lembert pattern for jejunojejunosotomy can be beneficial, as it minimizes the time taken and results in a larger stoma than the two-layer anastomosis.

These findings suggest that a change in surgical practice may be beneficial, potentially leading to improved recovery outcomes for equine patients.

Cite This Article

APA
Nieto JE, Dechant JE, Snyder JR. (2006). Comparison of one-layer (continuous Lembert) versus two-layer (simple continuous/Cushing) hand-sewn end-to-end anastomosis in equine jejunum. Vet Surg, 35(7), 669-673. https://doi.org/10.1111/j.1532-950X.2006.00206.x

Publication

Veterinary surgery : VS
ISSN: 0161-3499
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 35
Issue: 7
Pages: 669-673

Researcher Affiliations

Nieto, Jorge E
  • Department of Surgical and Radiological Sciences Comparative Gastroenterology Laboratory, School of Veterinary Medicine, University of California - Davis, Davis, CA, USA. jenieto@ucdavis.edu
Dechant, Julie E
    Snyder, Jack R

      MeSH Terms

      • Anastomosis, Surgical / methods
      • Anastomosis, Surgical / veterinary
      • Animals
      • Biomechanical Phenomena
      • Female
      • Horse Diseases / surgery
      • Horses
      • In Vitro Techniques
      • Jejunum / surgery
      • Male
      • Suture Techniques / veterinary
      • Time Factors
      • Treatment Outcome

      Citations

      This article has been cited 10 times.
      1. Liu M, Zhang M, Ren X, Liu C, Yu H, Xu XL, Ding GJ, Fu T, Geng L, Cheng F. Asymmetric figure-of-eight single-layer suture technique for intestinal anastomosis: A preliminary study. Front Surg 2023;10:1109751.
        doi: 10.3389/fsurg.2023.1109751pubmed: 36860948google scholar: lookup
      2. Liu C, Wang Y, Zhao AR, Hu FA, Fan Q, Han G, Ding G, Fu T, Geng L, Yin H. An alternative asymmetric figure-of-eight single-layer suture technique for bowel anastomosis in an in vitro porcine model. Front Surg 2022;9:896542.
        doi: 10.3389/fsurg.2022.896542pubmed: 36248362google scholar: lookup
      3. Lenoir A, Perrin BRM, Lepage OM. Ex Vivo Comparison of a UV-Polymerizable Methacrylate Adhesive versus an Inverting Pattern as the Second Layer of a Two-Layer Hand-Sewn Jejunal Anastomosis in Horses: A Pilot Study. Vet Med Int 2021;2021:5545758.
        doi: 10.1155/2021/5545758pubmed: 33884160google scholar: lookup
      4. Averay K, van Galen G, Ward M, Verwilghen D. Effect of three different needle holders on gastrointestinal anastomosis construction time and bursting pressure in equine jejunal segments. BMC Vet Res 2021 Apr 15;17(1):167.
        doi: 10.1186/s12917-021-02871-4pubmed: 33858391google scholar: lookup
      5. Bracamonte JL, Devick I, Thomas KL, Hendrick S. Comparison of hand-sewn and oversewn stapled jejunojejunal anastomoses in horses. Can Vet J 2018 Jan;59(1):67-73.
        pubmed: 29302105
      6. Rosser JM, Brounts S, Livesey M, Wiedmeyer K. Comparison of single layer staple closure versus double layer hand-sewn closure for equine pelvic flexure enterotomy. Can Vet J 2012 Jun;53(6):665-9.
        pubmed: 23204588
      7. Rosser J, Brounts S, Slone D, Lynch T, Livesey M, Hughes F, Clark C. Pelvic flexure enterotomy closure in the horse with a TA-90 stapling device: a retrospective clinical study of 84 cases (2001-2008). Can Vet J 2012 Jun;53(6):643-7.
        pubmed: 23204584
      8. Davis HA, Munsterman A. Ileal impaction and jejunal enterotomy in a 4-month-old Arabian filly. Can Vet J 2012 Jan;53(1):71-4.
        pubmed: 22753967
      9. Al-Timmemi HA, Al-Jashamy K, Dauod MS. A comparison of two anastomotic techniques in the jejunum of the goat. Vet Med Int 2010 Nov 1;2010:139610.
        doi: 10.4061/2010/139610pubmed: 21052536google scholar: lookup
      10. Baldwin CM, Gillen A. An ex vivo comparison of jejunal transection angles and the effect on lumen diameter following end-to-end jejunojejunal anastomoses. Vet Surg 2026 Feb;55(2):484-490.
        doi: 10.1111/vsu.14294pubmed: 40525474google scholar: lookup
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