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Equine veterinary journal2023; doi: 10.1111/evj.13926

Use of a new device for inversion of the necrotic ileal stump in the caecum in four horses.

Abstract: In jejunocaecal anastomosis leaving a necrotic ileal stump has been implicated in complications and poor outcomes. Elective inversion of the necrotic stump using a nasogastric tube has been previously described, although this procedure can be cumbersome and can cause caecocolic orifice occlusion. Objective: To describe the use of a new device for elective inversion of necrotic ileal stumps. Methods: Case report. Methods: Details of the four horses that underwent intestinal resection and anastomosis with elective inversion of the ileal stump were retrieved from their medical records. For each case, a device was constructed by securing 0.7 m of hemp tape to a 0.5 m long electrical cable puller. The device was inserted into the ileum and passed through the caecum. The ileal lumen was closed using sutures or staples, and the tape was simultaneously secured to the intestine. The ileum was then resected. A small typhlotomy was performed at the proposed site for jejunocaecal anastomosis. The device was retrieved, the hemp tape was cut, and jejunocaecal anastomosis was completed. Results: The device was easily secured to the intestines. Small enterotomies were sufficient for device insertion and removal. In four clinical cases the procedure was effective in inverting the stump, and three out of the four horses recovered uneventfully and were discharged from the hospital. One horse was euthanised due to colic 27 months following discharge. Conclusions: Small number of cases admitted to single tertiary hospital. Conclusions: The device was effective in inverting the ileal stump in the included clinical cases. By leaving a short, inverted stump, this method may help improve the prognosis for jejunocaecal anastomosis, possibly avoiding certain undesired effects of the procedure. Further studies with large numbers of cases are required.
© 2023 EVJ Ltd.
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Publication Date: 2023-01-16 PubMed ID: 36645415DOI: 10.1111/evj.13926Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The study investigates the use of a custom-made device in performing an elective inversion of necrotic ileal stumps in horses during jejunocaecal anastomosis, a technique that effectively mitigated complications associated with leaving a necrotic stump post-surgery in four clinical cases.

Objective and Methodology of the Research

The study aimed to introduce a newly created device to perform an inversion of necrotic ileal stumps during jejunocaecal anastomosis in horses.

  • This was motivated by the understanding that leaving a necrotic ileal stump has been linked to post-surgical complications and poor performance outcomes.
  • A device was fashioned for each case by securing a 0.7m stretch of hemp tape to a 0.5m long electrical cable puller.
  • The device was introduced into the ileum and navigated through the caecum. Sutures or staples were used to close the ileal lumen while the tape was anchored to the intestine. Subsequently, the ileum was resected.
  • A minor typhlotomy was carried out at the would-be site for jejunocaecal anastomosis. The device was then salvaged, the hemp tape cut, and jejunocaecal anastomosis completed.
  • The process and outcome of the study were collated from the medical records of the four horses that had intestinal resection and anastomosis with elective inversion of the ileal stump.

Findings and Conclusion

The custom-made device was found to be effective in the elective inversion procedure, given:

  • The device was easily attached to the intestines, and small incisions were sufficient for its insertion and removal.
  • Out of the four treated horses, the procedure was successful in inverting the stump; three of the horses recovered without complications and were discharged from the hospital.
  • One horse was euthanized due to colic 27 months after being discharged.

The researchers concluded that the method implemented in this study may improve the prognosis associated with jejunocaecal anastomosis by avoiding some potentially negative effects. Nevertheless, they acknowledged the limitations of their study, including the small sample size and the focus on a single tertiary hospital. Consequently, they suggested further large-scale studies to fully ascertain the efficacy and potential advantages of this approach.

Cite This Article

APA
Gandini M, Giusto G. (2023). Use of a new device for inversion of the necrotic ileal stump in the caecum in four horses. Equine Vet J. https://doi.org/10.1111/evj.13926

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Gandini, Marco
  • Department of Veterinary Sciences, University of Turin, Turin, Italy.
Giusto, Gessica
  • Department of Veterinary Sciences, University of Turin, Turin, Italy.

References

This article includes 24 references
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