Ex vivo comparison of three hand sewn end-to-end anastomoses in normal equine jejunum.

The research compared three methods of hand-sewn intestinal connections in horses. The researchers found that a specific single layer sewing method named 1C was quicker to construct and as robust as the traditional double layer method, offering potential for use in equine surgery.

Research Overview

The purpose of the study was to evaluate the characteristics of two single layer techniques for making end-to-end connections in the small intestine of horses, as compared to the double layer method traditionally used in equine surgery. Features like construction time, burst pressure tolerance and reduction in the intestinal lumen size were the key parameters scrutinised in the evaluation.

Research Methodology

• The intestine segments of horses (jejunum) were harvested and used for creating end-to-end connections specific to each of the three methods: double layer simple continuous/Cushing pattern (2C), single layer Lembert pattern (1L), and single layer Cushing pattern (1C).
• The time taken to make each connection was noted.
• The produced intestines were filled with gas to measure their bursting pressure and understand how they failed.
• The reduction in the lumen size of the intestines was calculated as a percentage decrease from the control group.
• These results were then compared using an ANOVA statistical technique and any value below 0.05 indicated a significant difference.

Research Findings

• The single-layer Cushing (1C) connections were found to be the quickest to construct, followed by the single-layer Lembert (1L) and then the double-layer connections (3C).
• In terms of bursting pressures, there were no significant differences observed between different suturing techniques and the control group.
• All techniques resulted in some reduction in lumen size, with no observable differences between each method.

Research Conclusion

• The study concluded that single layer techniques were quicker to construct than double layer methods, with the 1C technique being fastest.
• In terms of strength and lumen size reduction, single layer techniques were comparable to the traditional double layer technique.
• The 1C technique was found more desirable due to less exposure of potentially adhesiogenic (causing adherence of body tissues) suture material, as compared to the 1L technique.
• Given the observed benefits, it was suggested that the 1C anastomosis might be a better choice for equine small intestine anastomosis. However, the researchers noted more in vivo studies are needed to confirm this.