End-to-end jejuno-ileal anastomosis following resection of strangulated small intestine in horses: a comparative study.
Abstract: Small intestinal resection and anastomosis is a relatively common procedure in equine surgical practice. This study was designed to test objectively the subjective opinions of surgeons at the Liphook Equine Hospital that an end-to-end jejuno-ileal anastomosis (JIA) is an effective and clinically justifiable procedure, contrary to conventional recommendations. Objective: An end-to-end JIA carries no greater risk of morbidity and mortality than an end-to-end jejunojejunal anastomosis (JJA). Methods: A retrospective observational study was performed on a population of 100 horses that had undergone small intestinal resection and end-to-end anastomosis. Two groups were identified; Group 1 (n = 30) had undergone an end-to- end JIA and Group 2 (n = 70) an end-to-end JJA. The 2 populations were tested for pre- and intraoperative comparability and for their equivalence of outcomes. Results: The 2 populations were comparable in terms of their distributions of preoperative parameters and type of lesion present. The observations used as outcome parameters (incidence risk of post operative colic, incidence risk of post operative ileus, duration of post operative ileus, rates of functioning original anastomoses at the time of discharge and at 12 months, survival rates at 6 months and 12 months) were equivalent between the 2 groups. Conclusions: End-to-end JIA carries no greater risk of morbidity and mortality than an end-to-end JJA. Conclusions: Surgeons faced with strangulating obstructions involving the jejuno-ileal junction in which there remains an accessible length of viable terminal ileum may reasonably perform an end-to-end JIA. This has the potentially significant advantage over a jejunocaecal anastomosis of preserving more anatomical and physiological normality to the intestinal tract. The study was, however, relatively small for an equivalence study and greater confidence would be gained with higher numbers.
Publication Date: 2005-07-21 PubMed ID: 16028627DOI: 10.2746/0425164054529463Google Scholar: Lookup
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- Comparative Study
- Journal Article
- Research Support
- Non-U.S. Gov't
- Clinical Study
- Colic
- Comparative Study
- Disease Treatment
- Equine Diseases
- Equine Health
- Gastrointestinal Health
- Horses
- Intestinal Pathology
- Intestinal Surgery
- Mortality
- Observational Study
- Post-Operative Period
- Retrospective Study
- Risk Factors
- Surgery
- Veterinary Care
- Veterinary Medicine
- Veterinary Practice
- Veterinary Procedure
Summary
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This research paper examines the effectiveness of end-to-end jejuno-ileal anastomosis, a surgical procedure performed on horses’ small intestines, against traditional surgical recommendations. The study uses previous surgery data to determine whether this procedure carries more risk than anastomosis between parts of the jejunum.
Objective
- The objective of this study was to determine if an end-to-end jejuno-ileal anastomosis (JIA) carries a higher risk of poor outcomes for the animals compared to a more traditionally performed end-to-end jejunojejunal anastomosis (JJA). It was hypothesized that there would be no greater risk for the JIA procedure over the JJA.
Methods
- The authors carried out a retrospective observational study on 100 horses that previously underwent small intestine resection and end-to-end anastomosis procedure.
- The horses were divided into two groups. Group 1, consisting of 30 animals, had an end-to-end JIA procedure, and Group 2, with 70 animals, had an end-to-end JJA procedure.
- The two groups were compared for pre and intraoperative similarities and how alike the outcomes were.
Results
- The results showed that the two groups were similarly matched in terms of preoperative parameters and type of lesions present, indicating that the conditions were similar in both groups before surgery.
- Outcomes such as the risk of colic after surgery, postoperative ileus occurrence and its duration, the performance of original anastomoses at discharge and at 12 months, as well as survival rates at 6 months and 12 months, were equivalent in both groups. This suggests that the end-to-end JIA procedure did not cause a greater risk of morbidity and mortality than the JJA procedure.
Conclusions
- End-to-end JIA is as safe as the traditional JJA procedure which should reassure surgeons working on obstructions involving the jejuno-ileal junction where viable terminal ileum sections are available.
- Giving a significant advantage over a jejunocaecal anastomosis the JIA procedure enables more preservation of the intestines’ anatomical and physiological normality.
- The researchers, however, acknowledge that their study was relatively small for an equivalence study and that a larger number of study subjects would bolster confidence in the findings.
Cite This Article
APA
Rendle DI, Woodt JL, Summerhays GE, Walmsley JP, Boswell JC, Phillips TJ.
(2005).
End-to-end jejuno-ileal anastomosis following resection of strangulated small intestine in horses: a comparative study.
Equine Vet J, 37(4), 356-359.
https://doi.org/10.2746/0425164054529463 Publication
Researcher Affiliations
- The Liphook Equine Hospital, Forest Mere, Liphook, Hampshire GU30 7JG, UK.
MeSH Terms
- Animals
- Horse Diseases / mortality
- Horse Diseases / surgery
- Horses
- Intestinal Obstruction / mortality
- Intestinal Obstruction / surgery
- Intestinal Obstruction / veterinary
- Intestine, Small / surgery
- Jejunoileal Bypass / mortality
- Jejunoileal Bypass / veterinary
- Postoperative Complications / veterinary
- Retrospective Studies
- Survival Analysis
- Treatment Outcome
Citations
This article has been cited 2 times.- 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.
- Anderson SL, Blackford JT, Kelmer SG. Clinical evaluation of a closed, one-stage, stapled, functional, end-to-end jejuno-ileal anastomosis in 5 horses. Can Vet J 2012 Sep;53(9):987-91.
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