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Veterinary surgery : VS2024; doi: 10.1111/vsu.14150

Ex vivo comparison of one-layer versus two-layer closures in end-to-end anastomoses in normal equine descending colon.

Abstract: The aim of the study was to evaluate time to closure, bursting pressures and luminal diameters of a single and double-layer end-to-end anastomoses in normal equine descending colon. Methods: Experimental study. Methods: Eight adult horses. Methods: Four segments of descending colon from each horse were randomly assigned to a control (n = 8, CON), one-layer (n = 12, group 1; continuous Lembert pattern), or two-layer group (n = 12, group 2; simple continuous oversewn with Cushing pattern). Anastomoses were performed, and time to closure and luminal diameter were measured. Bursting pressures were determined, and location of failure was recorded. Mixed analysis of variance (ANOVA) was employed. Results: Mean time to completion was decreased (p = .003) in group 1 (18.6 min ± 22.8 s) compared with group 2 (21.35 min ± 22.8 s). Luminal diameter was reduced (p < .0001) in group 2 (47 ± 2.46 mm) compared to group 1 (65 ± 2.77 mm). Location of failure was remote to the anastomosis in all but one segment; therefore, differences in anastomotic bursting pressures could not be determined. Conclusions: Two-layer closures resulted in significant luminal reduction and took longer to complete than one-layer anastomoses. Conclusions: Use of one-layer closures may be advantageous primarily with respect to luminal diameter.
Publication Date: 2024-09-05 PubMed ID: 39235049DOI: 10.1111/vsu.14150Google Scholar: Lookup
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  • Journal Article

Summary

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The research compares the differences between one-layer and two-layer surgical closures in the descending colon of horses. The study found that one-layer closures took less time to perform and resulted in a wider luminal diameter, suggesting potential advantages over two-layer closures.

Objective and Methods

  • The research aimed to assess the efficiency and outcomes of one-layer versus two-layer surgical closures in the descending colon of horses. Specifically, it focused on the time it takes to perform the closure, the resilience of the closure as measured by its bursting pressure, and the resultant diameter of the colon’s lumen.
  • The study used eight adult horses and separated four segments of each horse’s descending colon into three categories: a control group (eight segments), a one-layer group (twelve segments) with a continuous Lembert pattern, and a two-layer group (twelve segments) with a simple continuous pattern oversewn with a Cushing pattern.
  • After performing the closures, the time to closure, lumen diameter, and bursting pressures were measured and recorded. The points of failure were also noted down. Mixed analysis of variance (ANOVA) was used for the analysis of the results.

Findings

  • The study revealed that one-layer closures took less time, with an average duration of 18.6 minutes, compared to the two-layer closure method, which took around 21.35 minutes. This implies that one-layer closures are more time-efficient in surgical settings.
  • Moreover, the one-layer closures resulted in a wider luminal diameter (an average of 65mm) compared to the two-layer closures (an average of 47mm). A wider lumen might promote better bowel function post-surgery as it facilitates smoother passing of contents.
  • The bursting pressures of the closures were not compared due to consistent remote failures, showing that failures did not typically occur at the site of the anastomosis.

Conclusions

  • The two-layer closure method took more time and resulted in smaller luminal diameters than the one-layer method in the equine descending colon.
  • The study concluded that one-layer closures might be beneficial over two-layer closures primarily due to the larger luminal diameter post-surgery. However, the resilience of closures, as determined by bursting pressures, could not be compared in this study.

Cite This Article

APA
St Blanc MP, Mirza MH, Riggs LM, Leise BS. (2024). Ex vivo comparison of one-layer versus two-layer closures in end-to-end anastomoses in normal equine descending colon. Vet Surg. https://doi.org/10.1111/vsu.14150

Publication

ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English

Researcher Affiliations

St Blanc, Michael P
  • Department of Veterinary Clinical Sciences, Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana, USA.
Mirza, Mustajab H
  • Department of Veterinary Clinical Sciences, Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana, USA.
Riggs, Laura M
  • Department of Veterinary Clinical Sciences, Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana, USA.
Leise, Britta S
  • Department of Veterinary Clinical Sciences, Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana, USA.

Grant Funding

  • School of Veterinary Medicine, Louisiana State University LSU Department of Veterinary Clinical Sciences Com

References

This article includes 28 references
  1. Dart AJ, Snyder JR, Pascoe JR, Farver TB, Galuppo LD. Abnormal conditions of the equine descending (small) colon: 102 cases (1979‐1989). J Am Vet Med Assoc 1992;200:971‐978.
  2. Prange T, Holcombe SJ, Brown JA. Resection and anastomosis of the descending colon in 43 horses. Vet Surg 2010;39:748‐753.
  3. deBont MP, Proudman CJ, Archer DC. Surgical lesions of the small colon and post operative survival in a UK hospital population. Equine Vet J 2013;45:460‐464.
  4. Hanson RR, Nixon AJ, Calderwood‐Mays M, Gronwall R, Pendergast JF. Comparison of staple and suture techniques for end‐to‐end anastomosis of the small colon in horses. Am J Vet Res 1988;49:1621‐1628.
  5. Bristol DG, Cullen J. A comparison of three methods of end‐to‐end anastomosis in the equine small colon. Cornell Vet 1988;78:325‐337.
  6. Hanson RR, Nixon AJ, Calderwood‐Mays M, Gronwall R. Evaluation of three techniques for end‐to end anastomosis of the small colon in horses. Am J Vet Res 1988;49:1613‐1620.
  7. Dart AJ, Snyder JR, Pascoe JR. Resection and anastomosis of the small colon in four horses. Aust Vet J 1992;69:5‐7.
  8. Auer JS, Stick JA, Kummerle JM, Prange T. Equine Surgery. 5th ed. Elsevier; 2019.
  9. Edwards GB. A review of 38 cases of small colon obstruction in the horse. Equine Vet J 1992;24:42‐50.
  10. Lee WL, Epstein KL, Sherlock CE, Mueller POE, Eggleston RB. In vitro comparison of a single‐layer (continuous Lembert) versus two‐layer (simple continuous/Cushing) hand‐sewn end‐to‐end jejunoileal anastomosis in normal equine small intestine. Vet Surg 2012;41:589‐593.
  11. Nelson BB, Hassel DM. In vitro comparison of V‐Loc™ versus Biosyn™ in a one‐layer end‐to‐end anastomosis of equine jejunum. Vet Surg 2014;43:80‐84.
  12. Nieto JE, Dechant JE, Snyder JR. Comparison of one‐layer (continuous Lembert) versus two‐layer (simple continuous/Cushing) hand‐sewn end‐to‐end anastomosis in equine jejunum. Vet Surg 2006;35:669‐673.
  13. Sherlock C, Lee W, Mueller P, Eggleston R, Epstein K. Ex vivo comparison of three hand sewn end‐to‐end anastomoses in normal equine jejunum. Equine Vet J Suppl 2011;43:76‐80.
  14. Bracamonte JL, Anderson SL, Hendrick S, Barber SM, Deutscher D, Sumner D. Ex vivo comparison of the biomechanical properties of hand‐sewn and stapled jejunoileal anastomoses in horses. Vet Surg 2014;43:451‐458.
  15. Roessner HA, Hurcombe SD, Klein CE, Hopster K, Engiles JB. Comparison of one‐layer Utrecht pattern with two‐layer (simple continuous/Cushing) pattern for jejunojejunostomy in healthy horses in vivo. Vet Surg 2021;50:1483‐1494.
  16. Seitz‐Cherner E, Bauck AG, Denagamage T, Freeman DE. Ex vivo and in vivo evaluation of a modified interrupted Lembert pattern for small intestinal anastomoses in horses. Vet Surg 2023;52:407‐415.
  17. Gandini M. In vitro evaluation of a closed‐bowel technique for one‐layer hand‐sewn inverting end‐to‐end jejunojejunosotomy in the horse. Vet Surg 2006;35:683‐688.
  18. AhChong AK, Chiu KM, Law IC, Chu MK, Yip AWC. Single‐layer continuous anastomosis in gastrointestinal surgery: a prospective audit. Aust N Z J Surg 1996;66:34‐36.
  19. Burch JM, Franciose RJ, Moore EE, Biffl WL, Offner PJ. Single‐layer continuous versus two‐layer interrupted intestinal anastomosis: a prospective randomized trial. Ann Surg 2000;231:832‐837.
  20. Mendez‐Angulo JL, Ernst NS, Mudge MC. Clinical assessment and outcome of a single‐layer technique for anastomosis of the small intestine in horses. Vet Rec 2010;167:652‐655.
  21. Close K, Epstein KL, Sherlock CE. A retrospective study comparing the outcome of horses undergoing small intestinal resection and anastomosis with a single layer (Lembert) or double layer (simple continuous and Cushing) technique. Vet Surg 2014;43:471‐478.
  22. Dart AJ, Snyder JR, Pascoe JR. Extensive resection and anastomosis of the descending (small) colon in a mare following strangulation by a mesenteric lipoma. Aust Vet J 1991;68:61‐64.
  23. Beard WL, Robertson JT, Getzy DM. Enterotomy technique in the descending colon of the horse. Effect of location and suture pattern. Vet Surg 1989;18:135‐140.
  24. Martens A, Haardt H. Role of laparoscopy in diagnosis and Management of Equine Colic. Vet Clin North Am Equine Pract 2023;39:339‐349.
  25. Alonso JM, Alves AL, Watanabe MJ, Rodrigues CA, Hussni CA. Peritoneal response to abdominal surgery: the role of equine abdominal adhesions and current prophylactic strategies. Vet Med Int 2014;2014:279730.
  26. Gorvy DA, Barrie Edwards G, Proudman CJ. Intra‐abdominal adhesions in horses: a retrospective evaluation of repeat laparotomy in 99 horses with acute gastrointestinal disease. Vet J 2008;175:194‐201.
  27. Faleiros RR, Macoris DG, Alessi AC, Saquetti CHC, Rasera L. Effect of intraluminal distention on microvascular perfusion in the equine small colon. Am J Vet Res 2002;63:1292‐1297.
  28. Faleiros RR, Macoris DG, Alves GE, Souza DG, Teixeira MM, Moore RM. Local and remote lesions in horses subjected to small colon distension and decompression. Can J Vet Res 2008;72:68‐76.

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