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.
Abstract: To compare in vitro physical and mechanical characteristics of 1-layer and 2-layer end-to-end jejunoileostomy. Methods: In vitro experimental study. Methods: Adult horses (n = 6). Methods: Harvested equine jejunum and ileum was used to create 1- and 2-layer end-to-end jejunoileostomy specimens. Construction time, bursting pressure, and relative lumen diameter (anastomosis diameter expressed as a percentage of the lumen diameter of adjacent jejunum and ileum) were compared. Construction time and relative lumen diameters were compared using a paired t-test. Bursting pressure for anastomoses and control jejunal segments were compared using a repeated-measure ANOVA. Statistical significance was set at P < .05. Results: Mean (± SEM) construct completion times were shorter for 1 layer (21 ± 0.91 minutes) than 2 layers (26.71 ± 1.16 minutes; P = .005). Relative lumen diameters (percentage of jejunal diameter) were larger for 1 layer (77.67 ± 4.46%) than for 2 layers (69.37 ± 2.8%; P = .035). There were no significant differences in bursting pressures between the 2 groups and the control jejunum (P =.155) or relative lumen diameters (percentage of ileal diameter; P =.118). Conclusions: One-layer jejunoileostomy can be created in a shorter time and maintain a larger anastomosis luminal diameter without compromising maximum bursting pressure when compared to 2-layer jejunoileostomy.
Copyright 2012 by The American College of Veterinary Surgeons.
Publication Date: 2012-06-25 PubMed ID: 22731983DOI: 10.1111/j.1532-950X.2012.00997.xGoogle Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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The research is focused on comparing the physical and mechanical characteristics of one-layer and two-layer surgical techniques, specifically end-to-end jejunoileostomy, on harvested equine small intestines. The findings suggest that one-layer technique is more efficient in terms of construct time and maintains a larger anastomosis luminal diameter than the two-layer technique without jeopardizing the maximum bursting pressure.
Research Methodology
- The study carried out an in vitro experimental procedure using harvested small intestines (jejunum and ileum) from 6 adult horses.
- Two surgical procedures were performed to create jejunoileostomy, which is a surgical connection between the jejunum and ileum. A one-layer and a two-layer technique were compared.
- Evaluation criteria included construction time, bursting pressure, and relative lumen diameter (the diameter of the anastomosis expressed as a percentage of the lumen diameter of the adjacent jejunum and ileum).
- Statistical analysis was done using paired T-test to compare construct times and relative lumen diameters. Repeated-measure ANOVA was used to compare bursting pressures.
Results
- The one-layer technique had shorter average completion times (21 minutes) as compared to the two-layer technique (26.71 minutes).
- The relative lumen diameter for the one-layer technique was significantly larger (77.67%) in comparison to the two-layer technique (69.37%).
- No significant differences were recorded in the bursting pressures between the two techniques or in the relative lumen diameters when compared to the control jejunum.
Conclusions
- The study concludes that a one-layer jejunoileostomy can be completed faster and maintains a larger anastomosis luminal diameter without compromising the maximum bursting pressure when compared to a two-layer jejunoileostomy.
- The findings imply that the one-layer technique could be a more efficient and equally safe option for this type of surgical procedure in equines.
Cite This Article
APA
Lee WL, Epstein KL, Sherlock CE, Mueller PO, Eggleston RB.
(2012).
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, 41(5), 589-593.
https://doi.org/10.1111/j.1532-950X.2012.00997.x Publication
Researcher Affiliations
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia Athens, GA 30602, USA.
MeSH Terms
- Anastomosis, Surgical / methods
- Anastomosis, Surgical / veterinary
- Animals
- Cadaver
- Female
- Horses
- Intestine, Small / surgery
- Male
- Suture Techniques / veterinary
- Sutures
Citations
This article has been cited 5 times.- 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.
- Lenoir A, Perrin BRM, Lepage OM. Ex Vivo Comparison of a UV-Polymerizable Methacrylate Adhesive versus an Inverting Pattern as the Second Layer of a Two-Layer Hand-Sewn Jejunal Anastomosis in Horses: A Pilot Study. Vet Med Int 2021;2021:5545758.
- 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.
- Bracamonte JL, Devick I, Thomas KL, Hendrick S. Comparison of hand-sewn and oversewn stapled jejunojejunal anastomoses in horses. Can Vet J 2018 Jan;59(1):67-73.
- Caziuc A, Dindelegan GC, Mironiuc A. Operator-related risk factors of anastomotic leaks after colorectal surgery: an up-to-date. Clujul Med 2015;88(2):124-7.
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