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Home / Equine Research Bank / Vet Surg / Comparison of one-layer Utrecht pattern with two-layer (simp...
Veterinary surgery : VS2021; 50(7); 1483-1494; doi: 10.1111/vsu.13679

Comparison of one-layer Utrecht pattern with two-layer (simple continuous/Cushing) pattern for jejunojejunostomy in healthy horses in vivo.

Abstract: To compare end-to-end jejunal anastomoses with a one-layer (Utrecht) and two-layer (simple continuous/Cushing) patterns. Methods: Experimental study. Methods: Eight healthy adult horses. Methods: Jejunal end-to-end anastomoses were performed in randomly assigned one-layer or two-layer patterns. Horses were recovered from surgery and monitored for complications. At 14 days, the opposite pattern was performed (cross-over design) prior to euthanasia. Duration of closures was compared between patterns. Serosal width was measured before harvesting anastomotic sites from the first procedure. Luminal diameter was measured, and sections were collected for histological evaluation of heating after routine and immunohistochemical staining. Results: One-layer closure was faster (716 ± 86 s) than two-layer closures (1136 ± 111 s). Postoperative complications were minimal. No difference was detected in lumen size between groups. The lumen was reduced by 18% after one-layer and 15% after two-layer closures (p = .34). Serosal adhesions to the mesentery without clinical evidence of obstruction were observed in two horses with two-layer closure. Histopathological scores for inflammation, infection, and healing did not differ between groups. Conclusions: Jejunal anastomosis with one-layer Utrecht technique was about 7 min faster and led to similar luminal reduction and histological healing scores as two-layer jejunojejunostomies. Conclusions: The outcomes of one-layer Utrecht jejunojejunostomies in healthy horses justify clinical evaluation of this technique.
© 2021 American College of Veterinary Surgeons.
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Publication Date: 2021-07-10 PubMed ID: 34245462DOI: 10.1111/vsu.13679Google Scholar: Lookup
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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.

The research focuses on comparing the effectiveness and efficiency of one-layer (Utrecht) and two-layer (simple continuous/Cushing) techniques for jejunojejunostomy (intestinal surgical reconnection) in healthy horses. The results demonstrate that the one-layer procedure was quicker, and outcomes were similar between the two techniques, suggesting that the one-layer method is a clinically justifiable alternative.

Study Design and Methodology

  • The researchers conducted an experimental study using eight healthy adult horses.
  • The horses underwent an end-to-end jejunal anastomosis, a surgical procedure to reconnect the intestine, using either a one-layer or two-layer technique. The decision on which technique to use was randomly assigned.
  • Post-surgery, the horses were observed for any complications. Then, after a period of 14 days, the horses had the opposite procedure performed.
  • To compare the effectiveness and efficiency of the techniques, the researchers analysed closure times, serosal width before sample collection, and luminal diameter.
  • In addition to this, tissue samples were collected for histological examination, allowing assessment of any inflammation, infection and healing processes.

Key Findings

  • The study found that one-layer closure was faster than two-layer closure (716 seconds compared to 1136 seconds on average).
  • Postoperative complications were minimal in both groups, suggesting both techniques were generally safe.
  • The size of the intestinal lumen (the hollow cavity inside the intestine) did not significantly differ between the two groups post-procedure, with the lumen being reduced by 18% after one-layer and 15% after two-layer closures. This is a statistical non-significant difference (p-value=0.34).
  • The study encountered two cases of serosal adhesions to the mesentery (the fold of membrane that attaches the intestine to the abdominal wall) from the group that had undergone two-layer closure. However, these did not result in any clinical symptoms of obstruction
  • Lastly, the histopathological evaluation (rating inflammation, infection, and healing) of tissue samples from the surgery sites showed no difference between the two groups.

Conclusions

  • The one-layer Utrecht technique for jejunal anastomosis was faster by approximately 7 minutes, and yielded similar results regarding luminal reduction and histological healing scores compared to the two-layer techniques.
  • The results of this study suggest that the one-layer Utrecht technique is a viable alternative for jejunojejunostomies in horses, and thus warrants further clinical evaluation.

Cite This Article

APA
Roessner HA, Hurcombe SD, Klein CE, Hopster K, Engiles JB. (2021). Comparison of one-layer Utrecht pattern with two-layer (simple continuous/Cushing) pattern for jejunojejunostomy in healthy horses in vivo. Vet Surg, 50(7), 1483-1494. https://doi.org/10.1111/vsu.13679

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 50
Issue: 7
Pages: 1483-1494

Researcher Affiliations

Roessner, Holly A
  • New Bolton Center, Department of Clinical Sciences, The University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Hurcombe, Samuel D
  • New Bolton Center, Department of Clinical Sciences, The University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Klein, Chelsea E
  • New Bolton Center, Department of Clinical Sciences, The University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Hopster, Klaus
  • New Bolton Center, Department of Clinical Sciences, The University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Engiles, Julie B
  • New Bolton Center, Department of Clinical Sciences, The University of Pennsylvania, Kennett Square, Pennsylvania, USA.

MeSH Terms

  • Anastomosis, Surgical / adverse effects
  • Anastomosis, Surgical / veterinary
  • Animals
  • Horse Diseases / surgery
  • Horses
  • Intestine, Small / surgery
  • Jejunum / surgery
  • Mesentery
  • Suture Techniques / veterinary
  • Tissue Adhesions / veterinary

Grant Funding

  • 1021791 / USDA National Institutes of Food and Agriculture (NIFA)

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This article includes 22 references
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Citations

This article has been cited 1 times.
  1. 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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