Sutured end-to-end and stapled side-to-side jejunal anastomoses in the horse.

The research investigates two different techniques of small intestinal anastomoses (surgical connection of two parts) in horses: the hand-sutured end-to-end method and the stapled side-to-side method. The study, conducted on 10 healthy horses, found no significant differences in surgery times, intra-abdominal adhesion scores, stomal areas, or histopathology scores using these two techniques.

Research Methodology

• The study was performed on 10 healthy adult horses. Within these 10 horses, a total of 15 hand sutured end-to-end (EE) and stapled side-to-side (SS) small intestinal anastomoses were carried out.
• For five of the SS anastomoses, staple lines on the blind ends of the jejunum (part of the small intestine) were inverted (SSI). In the other five, they were not inverted (SSNI).
• The EE anastomoses were achieved using two separate types of sutures: five were sewn with polydioxanone, and five with polyglyconate.
• All horses were euthanized on day 30 for further analysis.

Research Findings

• Intra-abdominal adhesions were graded between 0 to 4 and stomal areas were calculated from contrast radiographs made with the bowel distended.
• The researchers also employed histopathology scores for the anastomoses, these were based on the degree of inflammation, fibrosis and the alignment and healing of intestinal layers – each scored from 0 to 3.
• The average surgery time for the EE, SSI, and SSNI techniques were calculated, with no significant differences found between the different methods.
• Stomal areas were greater in the SS anastomosis; however, this did not appear to significantly affect the success of the surgery.
• Intra-abdominal adhesions developed in three horses, and one horse showed clinical signs of colic post surgery.
• Mean histopathology scores were slightly higher for the EE anastomosis but not to a degree that was statistically significant.

Research Conclusion

• The research concluded that there were no significant differences in surgery times, intra-abdominal adhesion scores, stomal areas or histopathology scores between small intestinal EE and SS anastomoses in these horses.
• This indicates that both techniques are equally viable for performing small intestinal anastomoses in horses, providing surgeons with multiple options to suit various scenarios and requirements.