Evaluation of the effect of onlay mesenteric flaps on end-to-end jejunojejunostomy healing in horses.
Abstract: To evaluate the effect of onlay mesenteric flaps (MFs) with end-to-end jejunojejunostomy on stomal diameter, length of jejunum with reduced stomal diameter, abdominal adhesion formation, and healing. Methods: Experimental study. Methods: Healthy adult horses (n = 6). Methods: Two hand sewn end-to-end jejunal anastomoses using a 1 layer simple continuous serosubmucosal suture pattern were performed in each horse ∼ 2 and 5 m oral to the ileocecal fold. Using a random design for selection anastomosis location (oral or aboral), 1 anastomosis was covered with 2 adjacent onlay MFs secured with interrupted sutures and cyanoacrylate glue. Two weeks later, adhesion formation, stomal diameter, length of reduced jejunal stomal diameter, and healing were evaluated. Results: Use of onlay MFs decreased stomal diameter (P = .05), increased length of reduced peristomal jejunal diameter (P = .05), surgical time (P = .003), and serosal fibrosis (P = .05). No difference was evident for adhesion formation, and degree of inflammation between techniques. Conclusions: End-to-end jejunojejunostomy covered with 2 onlay MFs is not recommended because this technique results in luminal reduction.
© Copyright 2014 by The American College of Veterinary Surgeons.
Publication Date: 2014-04-01 PubMed ID: 24689863DOI: 10.1111/j.1532-950X.2014.12120.xGoogle Scholar: Lookup
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- Journal Article
Summary
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This study investigates the impact of using onlay mesenteric flaps (MFs) in conjunction with end-to-end jejunojejunostomy (joining segments of the small intestine) in horses and found the technique leads to smaller intestinal diameters and is thus not recommended.
Experimental Methods
- Researchers conducted an experimental study using six healthy adult horses.
- Two hand-sewn end-to-end jejunal anastomoses (a surgical connection between two parts of the intestine) were implemented in each horse, approximately 2 and 5 meters oral to the ileocecal fold (the region where the small intestine meets the large intestine).
- For one of the anastomosis (selected randomly), onlay MFs were applied. An MF is a surgical procedure in which a flap of tissue from the mesentery (the structure that connects the intestines to the back of the abdominal wall) is positioned over the anastomosis. The flaps were secured with interrupted sutures and cyanoacrylate glue.
Observations and Results
- Two weeks post the initial procedure, several factors were examined: formation of adhesions (bands of scar tissue that can cause the intestines to stick together), the diameter of the stoma (the new connection between the two sections of the intestine), the length of reduced jejunal stomal diameter, and the general healing process.
- It was found that the use of MFs led to a decrease in the stomal diameter and an increase in the length of reduced peristomal jejunal diameter. Additionally, it was observed to increase the surgical time as well as lead to more serosal fibrosis (a type of scarring on the serosal surface which is the outermost cover of the organs in the abdominal cavity).
- However, there was no significant difference detected in terms of adhesion formation or the degree of inflammation between the two techniques.
Conclusions
- The researchers concluded from the study results that employing end-to-end jejunojejunostomy covered with 2 onlay MFs is not advised. The reason is that this technique leads to a reduction in the luminal space (the interior of the intestinal tube) which could potentially lead to complications either due to blockages or poor nutrient absorption.
Cite This Article
APA
Aristizabal FA, Lopes MA, Silva A, Avanza MF, Nieto JE.
(2014).
Evaluation of the effect of onlay mesenteric flaps on end-to-end jejunojejunostomy healing in horses.
Vet Surg, 43(4), 479-486.
https://doi.org/10.1111/j.1532-950X.2014.12120.x Publication
Researcher Affiliations
- Departamento de Médicina Veterinária, Universidade Federal de Viçosa, Viçosa, MG, Brazil.
MeSH Terms
- Animals
- Female
- Horses
- Jejunostomy / methods
- Jejunostomy / veterinary
- Male
- Mesentery / surgery
- Postoperative Complications / pathology
- Postoperative Complications / veterinary
- Surgical Flaps / veterinary
- Suture Techniques / veterinary
- Wound Healing / physiology
Citations
This article has been cited 1 times.- Giusto G, Iussich S, Tursi M, Perona G, Gandini M. Comparison of two different barbed suture materials for end-to-end jejuno-jejunal anastomosis in pigs.. Acta Vet Scand 2019 Jan 5;61(1):3.
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