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Tallon RE, Allen SE, Bladon BM, McGovern KF. Retrospective evaluation of the effects of a single intraoperative dose of dexamethasone in horses undergoing exploratory laparotomy for small intestinal lesions (2008-2019): 240 cases. J Vet Emerg Crit Care (San Antonio) 2024; 34:245-251. [PMID: 38809185 DOI: 10.1111/vec.13374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 11/11/2022] [Accepted: 01/06/2023] [Indexed: 05/30/2024]
Abstract
OBJECTIVE To determine the effect of a single intraoperative dose of dexamethasone on the risk of postoperative reflux (POR) in horses undergoing small intestinal surgery and to investigate its association with incisional complications and short-term survival. DESIGN Retrospective cohort study over an 11-year period (2008-2019). SETTING UK-based private referral center. ANIMALS Two hundred and forty client-owned horses >6 months of age undergoing exploratory laparotomy for treatment of a small intestinal lesion. INTERVENTIONS Ninety-seven horses received a single intraoperative dose of dexamethasone (0.1 mg/kg, IV). MEASUREMENTS AND MAIN RESULTS Of 97 horses that received dexamethasone, 52 (53.6%) required small intestinal resection. Of 143 horses that did not receive dexamethasone, small intestinal resection was performed in 78 (54.5%). A total of 70 horses (29%) developed POR. There was no difference in the risk of POR between horses that received dexamethasone (25/97; 26%) and those that did not (45/143; 31%, P = 0.34). Risk factors associated with the development of POR included small intestinal resection (odds ratio [OR]: 4.55, 95% confidence interval [CI]: 2.27-9.11, P < 0.001), a PCV >40% 24 hours postoperatively (OR: 4.11, 95% CI: 2-8.45, P < 0.001), and a WBC count >10 × 109/L on admission (OR: 3.29, 95% CI: 1.47-7.41, P = 0.004). Dexamethasone was not associated with the odds of POR. Horses undergoing repeat laparotomy had a higher risk of incisional infection (OR: 8.07, 95% CI: 1.98-32.81, P = 0.004). Dexamethasone administration was not associated with incisional infection. The development of POR was negatively associated with short-term survival (OR: 0.07, 95% CI: 0.03-0.17, P ≤ 0.001). Dexamethasone administration was not retained in the final multivariable model for survival. CONCLUSIONS Intraoperative dexamethasone was not associated with the development of POR in this study population, nor did it have an effect on postoperative survival or incisional infection in horses undergoing surgical management of small intestinal disease.
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Affiliation(s)
| | - Sarah E Allen
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, UK
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Giusto G, Cerullo A, Gandini M. Anastomotic techniques for small intestinal obstruction in horses. A scoping review. Equine Vet J 2024. [PMID: 38379364 DOI: 10.1111/evj.14076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/05/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Small bowel obstruction (SBO) is a significant cause of surgery in adult horses presenting with colic pain. SBOs often require resection and anastomosis. While various techniques for intestinal anastomoses have been developed, it remains uncertain if any fully meet our clinical needs. OBJECTIVE To conduct a scoping review of publications on anastomosis techniques and outcomes for the treatment of SBO. STUDY DESIGN Scoping review. METHODS A literature review was conducted using the CAB, Web of Science, Scopus, and PubMed databases. Peer-reviewed scientific articles in English, published between 1992 and 2023, were included. A quality assessment was performed for potentially eligible articles. Experimental studies, case reports, and case series with less than five cases were excluded and relevant data on study methods and sample size were extracted and charted from remaining articles. Anastomosis type and outcome were reported for articles considered potentially eligible for meta-analysis. Articles in which only overall outcome was reported or details on type of anastomosis were not reported were excluded for the final charting. RESULTS Of 3024 articles, 210 underwent a quality assessment. The most common study designs were case reports and case series (64.3%), followed by experimental studies (17.1%). After further exclusions, 104 articles met the inclusion criteria. In only 42 articles detailed data on type of anastomosis and relative outcome were reported. A total of 23 anastomosis types were reported for the treatment of SBO, with 6 different outcomes evaluated. Both short- and long-term survival rates consistently exceed 70% for all types of anastomosis (jejuno-jejunal, jejuno-ileal, and jejunocaecal). MAIN LIMITATION Non-English language studies and conference proceedings were excluded. CONCLUSION The body of literature focused on surgical treatment for SBO exhibits low-quality evidence. Several techniques of anastomosis were described for different pathologies. However, there is a lack of homogeneity in reporting outcome for each surgical technique. Furthermore, outcomes considered varied significantly among studies and were sometimes poorly reported, although success rates are generally high. Overall, there is a need for better-structured studies on existing and commonly used techniques before comparing techniques and exploring other innovative approaches.
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Affiliation(s)
- Gessica Giusto
- Department of Veterinary Sciences, University of Turin, Turin, Italy
| | - Anna Cerullo
- Department of Veterinary Sciences, University of Turin, Turin, Italy
| | - Marco Gandini
- Department of Veterinary Sciences, University of Turin, Turin, Italy
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Gandini M, Giusto G. Use of a new device for inversion of the necrotic ileal stump in the caecum in four horses. Equine Vet J 2023; 55:1021-1028. [PMID: 36645415 DOI: 10.1111/evj.13926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 01/05/2023] [Indexed: 01/17/2023]
Abstract
BACKGROUND 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. STUDY DESIGN 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. MAIN LIMITATIONS 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.
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Affiliation(s)
- Marco Gandini
- Department of Veterinary Sciences, University of Turin, Turin, Italy
| | - Gessica Giusto
- Department of Veterinary Sciences, University of Turin, Turin, Italy
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4
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Veerasammy B, Gonzalez G, Báez-Ramos P, Schaaf CR, Stewart AS, Ludwig EK, McKinney-Aguirre C, Freund J, Robertson J, Gonzalez LM. Changes in equine intestinal stem/progenitor cell number at resection margins in cases of small intestinal strangulation. Equine Vet J 2023; 55:995-1002. [PMID: 36716291 PMCID: PMC10387127 DOI: 10.1111/evj.13927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 01/26/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Intestinal epithelial stem cells (ISC) are responsible for epithelial regeneration and are critical to the intestine's ability to regain barrier function following injury. Evaluating ISC biomarker expression in cases of small intestinal strangulation (SIS) may provide insight into clinical progression. OBJECTIVES Intestinal resection margins from cases of SIS were evaluated to determine if (1) evidence of injury could be identified using histomorphometry, (2) ISC biomarker expression was decreased in the proximal resection margin compared to control and distal resection margin, and (3) the ISC biomarker expression was associated with the number of preoperative risk factors negatively related to outcome, post-operative complications, or case outcome. STUDY DESIGN Retrospective cohort study. METHODS Intestinal samples were obtained intraoperatively from resection margins of adult horses with SIS and horses euthanised for reasons unrelated to colic. Preoperative risk factors negatively related to outcome, post-operative complications, and case outcome were obtained from medical records. Horses were grouped as euthanised intraoperatively, postoperatively, or survived to discharge. Histomorphometry and immunofluorescence were performed to evaluate tissue architecture and ISC and progenitor cell number. Groups were compared using one-way ANOVA. Associations between biomarker expression and the number of preoperative risk factors and post-operative complications negatively related to outcome were determined using linear regression modelling. RESULTS Thirty-six cases of SIS were evaluated. Ki67+ cell counts were decreased in the proximal (mean = 15.45 cells; 95% CI = 10.27-20.63; SD = 4.17; p = 0.02) and distal resection margins (mean = 15.05; 95% CI = 8.46-21.64; SD = 4.141; p = 0.03) in horses euthanised postoperatively compared to control (mean = 23.62 cells; 95% CI = 19.42-27.83; SD = 5.883). In the distal resection margin, an increase in SOX9+ Ki67+ cells were associated with a decrease in the total number of preoperative risk factors negatively related to outcome (95% CI = 0.236-1.123; p = 0.008, SE = 0.1393). MAIN LIMITATIONS Small population size. CONCLUSIONS Proliferating cell and ISC numbers may be associated with case outcome.
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Affiliation(s)
- Brittany Veerasammy
- North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - Gabriel Gonzalez
- North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - Patricia Báez-Ramos
- North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - Cecilia R Schaaf
- North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - Amy Stieler Stewart
- North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - Elsa K Ludwig
- North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina, USA
| | | | - John Freund
- North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - James Robertson
- North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - Liara M Gonzalez
- North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina, USA
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Spadari A, Gialletti R, Gandini M, Valle E, Cerullo A, Cavallini D, Bertoletti A, Rinnovati R, Forni G, Scilimati N, Giusto G. Short-Term Survival and Postoperative Complications Rates in Horses Undergoing Colic Surgery: A Multicentre Study. Animals (Basel) 2023; 13:ani13061107. [PMID: 36978647 PMCID: PMC10044551 DOI: 10.3390/ani13061107] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/17/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023] Open
Abstract
The occurrence of colic could be influenced by the characteristics of a population, geographical area, and feeding management. The aim of this study was to report the short-term postoperative complications and survival rates and to identify factors that might affect the outcome of horses that underwent colic surgery in three Italian surgical referral centres. Data of horses subjected to colic surgery in three referral centres (2018-2021) were analysed. Comparisons of the outcomes were performed using a Mann-Whitney or a Chi square test. Areas under the receiver operating characteristic (ROC) curve and multivariable logistic regression analysis were used for parameters that were significant in the previous univariate analysis. The goodness-of-fit of the model was assessed using the Akike information criterion (AIC). Significance was defined as p < 0.05, and odds ratios and 95% confidence intervals were calculated as percentages. A total of 451 horses were included. The survival rate was 68.5% of all of the horses that underwent colic surgery and 80% of the horses surviving anaesthesia. Age, BCS, PCV and TPP before and after surgery, amount of reflux, type of disease, type of lesion, duration of surgery, surgeon's experience, and amount of intra- and postoperative fluids administered influenced the probability of short-term survival. The multivariate analysis revealed that PCV at arrival, TPP after surgery, and BCS had the highest predictive power. This is the first multicentre study in Italy. The results of this study may help surgeons to inform owners regarding the prognosis of colic surgery.
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Affiliation(s)
- Alessandro Spadari
- Department of Veterinary Medical Sciences, University of Bologna, 40136 Bologna, Italy
| | - Rodolfo Gialletti
- Veterinary Teaching Hospital, Department of Veterinary Medicine, 06123 Perugia, Italy
| | - Marco Gandini
- Department of Veterinary Sciences, University of Turin, 10095 Grugliasco, Italy
| | - Emanuela Valle
- Department of Veterinary Sciences, University of Turin, 10095 Grugliasco, Italy
| | - Anna Cerullo
- Department of Veterinary Sciences, University of Turin, 10095 Grugliasco, Italy
| | - Damiano Cavallini
- Department of Veterinary Medical Sciences, University of Bologna, 40136 Bologna, Italy
| | - Alice Bertoletti
- Veterinary Teaching Hospital, Department of Veterinary Medicine, 06123 Perugia, Italy
| | - Riccardo Rinnovati
- Department of Veterinary Medical Sciences, University of Bologna, 40136 Bologna, Italy
| | - Giulia Forni
- Department of Veterinary Medical Sciences, University of Bologna, 40136 Bologna, Italy
| | - Nicola Scilimati
- Veterinary Teaching Hospital, Department of Veterinary Medicine, 06123 Perugia, Italy
| | - Gessica Giusto
- Department of Veterinary Sciences, University of Turin, 10095 Grugliasco, Italy
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Gandini M, Cerullo A, Gallo L, Iussich S, Minoli L, Giusto G. Ex vivo evaluation of a technique for equine jejunocecal anastomosis using radiofrequency thermofusion and a Cushing oversew. Vet Surg 2023; 52:545-553. [PMID: 36922367 DOI: 10.1111/vsu.13946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 01/04/2023] [Accepted: 02/15/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To describe a technique for a side-to-side jejunocecal anastomosis in horses using radiofrequency thermofusion (TF) of the intestines supported by a Cushing oversew and to compare this anastomosis to handsewn and stapled techniques. STUDY DESIGN Ex vivo study. SAMPLE POPULATION Intestinal tracts from 24 slaughtered horses. METHODS A radiofrequency device was used to perform a jejunocecal anastomosis (Group RFA). The construction time and bursting pressure of this construct were compared with those of a hand-sewn double layer (Group HS) and stapled anastomoses (Group ST) without oversew of the staple line. Histology was also performed for the TF anastomoses to evaluate the extent of the thermal damage. RESULTS The median (range) construction time (min) for the TF (15.8 [14.4-16.8]) was not significantly different from that for the HS (25.5 [24.2-26.3]) and ST (10.8 [9.7-12.5]) groups (p = .07). The construction time for ST was shorter than that for HS group (p < .001). The average (standard deviation) bursting pressure (mmHg) for HS (153.1 +/- 17.5) was higher than that for RFA (76 +/- 15) and ST groups (48 +/- 13; p < .001). The bursting pressure of the RFA was higher than that of the ST anastomoses (p = .001). The thermal damage caused by the device was within the suture oversew in the deeper layers, whereas it extended a few mm beyond the suture line in the serosa. CONCLUSION Radiofrequency assisted anastomoses provide similar construction times to current techniques and have a higher bursting pressure than ST anastomoses. CLINICAL SIGNIFICANCE Radiofrequency-assisted anastomoses with a suture oversew demonstrated comparable bursting pressures to ST anastomoses. The use of the radiofrequency device on the intestine is extra label and causes serosal tissue damage, which may increase the risk of adhesions.
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Affiliation(s)
- Marco Gandini
- Department of Veterinary Sciences, University of Turin, Turin, Italy
| | - Anna Cerullo
- Department of Veterinary Sciences, University of Turin, Turin, Italy
| | - Livio Gallo
- Department of Veterinary Sciences, University of Turin, Turin, Italy
| | - Selina Iussich
- Department of Veterinary Sciences, University of Turin, Turin, Italy
| | - Lucia Minoli
- Department of Veterinary Sciences, University of Turin, Turin, Italy
| | - Gessica Giusto
- Department of Veterinary Sciences, University of Turin, Turin, Italy
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Rudnick MJ, Denagamage TN, Freeman DE. Effects of age, disease, and anastomosis on short- and long-term survival after surgical correction of small intestinal strangulating diseases in 89 horses. Equine Vet J 2022; 54:1031-1038. [PMID: 35023209 DOI: 10.1111/evj.13558] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 11/20/2021] [Accepted: 12/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although survival rates have been reported after small intestinal surgery for strangulating diseases in horses, none have followed survival for periods relevant to the long lifespan of horses and none have described effect of age, disease and surgical treatments over such long survival periods. OBJECTIVES To examine effects of age, disease, and type of surgery on long-term survival in horses after surgical treatment of small intestinal strangulating diseases over periods relevant to the expected lifespan of a horse. STUDY DESIGN Retrospective clinical study. METHODS Post-operative data were gathered from medical records and owner contact for 89 horses with small intestinal strangulation. Survival times from surgery to date of death or date of last follow-up were analysed by Kaplan-Meier statistics. Variables of interest were age, type of strangulating disease, and surgical correction. Cox proportional hazards regression was used to evaluate these variables. RESULTS Short-term survival was not affected by any of the variables measured. For long-term survival with Kaplan-Meier statistics, horses ≥16 years old had significantly shorter (P=0.002) median survival times (72 months; 95% C.I. 32.0-96.0) than younger horses (121.7 months; 95% C.I. 90.0-162), horses without resection had significantly longer (P=0.02) survival times (120 months; 95% C.I. 86-212) than horses that had jejunocecostomy (76.8 months; 95% C.I. 24-125), and horses with miscellaneous diseases had significantly longer (P=0.02) median survival times (161.9 months (95% C.I. 72.0-M) than horses with strangulating lipoma (79.8 months; 95% C.I. 32.0-120.0). In the multivariable Cox Proportional Hazard model, age (HR=2.67; 1.49-4.75, p<0.001) and anastomosis (HR=0.65; 0.46-0.92, P=0.02) had the most significant effect on median survival time. MAIN LIMITATIONS Limitations were small numbers in some categories, loss of cases to follow-up, owner recall failures, and lack of a control group. CONCLUSIONS The remaining lifespan of older horses at the time of surgery had the greatest effect on survival. Age could influence long-term survival studies after colic surgery, and therefore needs to be considered for survival analyses. Horses that did not require resection and anastomosis had favourable outcomes, underscoring the potential importance of early intervention to reduce the need for resection.
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Affiliation(s)
- Meredith J Rudnick
- University of Florida College of Veterinary Medicine, Department of Large Animal Clinical Sciences, PO Box 100136, Gainesville, Florida, 32610, USA
| | - Thomas N Denagamage
- University of Florida College of Veterinary Medicine, Department of Large Animal Clinical Sciences, PO Box 100136, Gainesville, Florida, 32610, USA
| | - David E Freeman
- University of Florida College of Veterinary Medicine, Department of Large Animal Clinical Sciences, PO Box 100136, Gainesville, Florida, 32610, USA
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Gandini M, Giusto G. Combination of end-to-end jejuno-ileal anastomosis and side-to-side incomplete ileocecal bypass (hybrid jejuno-ileo-cecal anastomosis) following subtotal ileal resection in seven horses. J Am Vet Med Assoc 2021; 259:1337-1343. [PMID: 34727065 DOI: 10.2460/javma.20.10.0577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION 7 horses (3 geldings, 2 mares, and 2 stallions) were examined because of acute colic caused by small intestinal obstruction involving the aborad portion of the jejunum and orad portion of the ileum. CLINICAL FINDINGS All horses underwent a routine colic examination on arrival and had a diagnosis of strangulating obstruction of the small intestine. TREATMENT AND OUTCOME All horses underwent emergency exploratory laparotomy, in which the affected aborad portion of the jejunum and orad portion of the ileum were resected; in 5 horses, a hand-sewn end-to-end jejuno-ileal anastomosis was combined with a hand-sewn incomplete ileocecal bypass to produce a hybrid jejuno-ileo-cecal anastomosis. In 2 horses, the hand-sewn end-to-end jejuno-ileal anastomosis was combined with a half-stapled, half-hand-sewn incomplete ileocecal bypass. The procedures restored continuity of the small intestine with partial bypass of the ileocecal valve. All horses survived to hospital discharge, and none developed colic or ileus during the postoperative period. Follow-up revealed that 6 horses were living and had no subsequent signs of colic (4 to 17 months after surgery), and 1 was euthanized because of colic 17 months after surgery. CLINICAL RELEVANCE Results for these horses suggested the hybrid jejuno-ileo-cecal anastomosis could be considered as an option for the resolution of small intestinal strangulating lesions involving the orad portion of the ileum. Studies are needed to assess short-term and long-term effects of the procedure in horses.
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Maleas G, Drumm N. Jejunocecostomy in a Grant's zebra (
Equus quagga boehmi
). VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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10
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Bergen T, Haspeslagh M, Wiemer P, Swagemakers M, van Loon G, Martens A. Surgical treatment of epiploic foramen entrapment in 142 horses (2008–2016). Vet Surg 2019; 48:291-298. [DOI: 10.1111/vsu.13161] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 12/05/2018] [Accepted: 12/15/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Thomas Bergen
- Department of Surgery and Anesthesiology of Domestic Animals, Faculty of Veterinary MedicineGhent University Merelbeke Belgium
- Clinique Equine d'Acy‐Romance Acy‐Romance France
| | - Maarten Haspeslagh
- Department of Surgery and Anesthesiology of Domestic Animals, Faculty of Veterinary MedicineGhent University Merelbeke Belgium
| | - Peter Wiemer
- Department of Surgery and Anesthesiology of Domestic Animals, Faculty of Veterinary MedicineGhent University Merelbeke Belgium
- De Lingehoeve Diergeneeskunde Lienden The Netherlands
| | - Michaël Swagemakers
- Department of Surgery and Anesthesiology of Domestic Animals, Faculty of Veterinary MedicineGhent University Merelbeke Belgium
| | - Gunther van Loon
- Department of Large Animal Internal Medicine, Faculty of Veterinary MedicineGhent University Merelbeke Belgium
| | - Ann Martens
- Department of Surgery and Anesthesiology of Domestic Animals, Faculty of Veterinary MedicineGhent University Merelbeke Belgium
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11
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Freeman DE. Fifty years of colic surgery. Equine Vet J 2018; 50:423-435. [DOI: 10.1111/evj.12817] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 12/05/2017] [Accepted: 01/10/2018] [Indexed: 12/21/2022]
Affiliation(s)
- D. E. Freeman
- Department of Large Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville Florida USA
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12
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Bauck AG, Easley JT, Cleary OB, Graham S, Morton AJ, Rötting AK, Schaeffer DJ, Smith AD, Freeman DE. Response to early repeat celiotomy in horses after a surgical treatment of jejunal strangulation. Vet Surg 2017; 46:843-850. [DOI: 10.1111/vsu.12670] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 12/23/2016] [Accepted: 02/03/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Anje G. Bauck
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - Jeremiah T. Easley
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - Orlaith B. Cleary
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - Sarah Graham
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - Alison J. Morton
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - Anna K. Rötting
- Department of Comparative Biosciences; University of Illinois, College of Veterinary Medicine; Urbana Illinois
| | - David J. Schaeffer
- Department of Comparative Biosciences; University of Illinois, College of Veterinary Medicine; Urbana Illinois
| | - Andrew D. Smith
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - David E. Freeman
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
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Mahne AT, Janse van Rensburg D, Hewetson M. Ileal hypertrophy and associated true diverticulum as a cause of colic in a horse. J S Afr Vet Assoc 2017; 88:e1-e5. [PMID: 28582984 PMCID: PMC6138206 DOI: 10.4102/jsava.v88i0.1439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 03/27/2017] [Accepted: 04/10/2017] [Indexed: 11/21/2022] Open
Abstract
A 4-year-old Thoroughbred gelding underwent an explorative celiotomy for a suspected small intestinal obstruction. During surgery, an impacted diverticulum of the ileum was suspected, necessitating a jejunocaecostomy. The owner opted for euthanasia. On post-mortem examination and histopathology, a true diverticulum on the mesenteric side of the ileum, with ileal hypertrophy, was diagnosed.
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Affiliation(s)
- Arnold T Mahne
- Department of Companion Animal Clinical Studies, University of Pretoria.
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Kilcoyne I, Dechant JE, Nieto JE. Comparison of clinical findings and short-term survival between horses with intestinal entrapment in the gastrosplenic ligament and horses with intestinal entrapment in the epiploic foramen. J Am Vet Med Assoc 2016; 249:660-7. [DOI: 10.2460/javma.249.6.660] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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15
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Salem SE, Proudman CJ, Archer DC. Has intravenous lidocaine improved the outcome in horses following surgical management of small intestinal lesions in a UK hospital population? BMC Vet Res 2016; 12:157. [PMID: 27459996 PMCID: PMC4962447 DOI: 10.1186/s12917-016-0784-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 07/20/2016] [Indexed: 12/14/2022] Open
Abstract
Background Perioperative lidocaine treatment is commonly used in horses that undergo surgical treatment of colic, to prevent or treat postoperative ileus and reduce the effects of intestinal ischaemia-reperfusion injury. However, its clinical efficacy has not been evaluated in a large population of horses undergoing small intestinal surgery. The aim of the current study was to evaluate whether systemic lidocaine administration reduced the prevalence, volume and duration of postoperative reflux and improved rates of survival following surgical treatment of small intestinal lesions. Data were collected as a part of two prospective studies investigating postoperative survival of surgical colic patients admitted to a UK equine referral hospital during the periods 2004–2006 and 2012–2014. Kaplan-Meier plots of cumulative probability of survival and the log-rank test were used to compare survival between horses that did or did not receive lidocaine. The Wilcoxon rank-sum test was used to compare the total reflux volume and duration of reflux between the groups. A multivariable Cox proportional hazards model was used to identify pre- and intraoperative risk factors for non-survival. Results Data from 318 horses were included in the final analysis. The overall prevalence of postoperative reflux was 24.5 %. This was significantly higher (34.8 %) in horses admitted in 2012–2014 compared to the 2004–2006 cohort (16.7). Perioperative lidocaine treatment had no effect on total reflux volume, duration of reflux or rates of postoperative survival nor was it a risk factor associated with altered postoperative survival. Variables identified to be associated with increased risk of postoperative mortality included packed cell volume on admission (hazard ratio [HR] 1.03 95 %, 95 % confidence interval [CI] 1.004–1.06, p = 0.024), heart rate on admission (HR 1.014, 95 % CI 1.004–1.024, p =0.008) and duration of surgery (HR 1.007, 95 % CI 1.002–1.01, p = 0.008). Conclusions Lidocaine therapy had no effect on the prevalence of postoperative reflux, total reflux volume and duration of reflux nor did it have any effect on postoperative survival in horses undergoing surgical management of small intestinal disease for treatment of colic. There is a need for a well-designed multicentre, prospective randomised controlled trial to fully investigate the efficacy of lidocaine across different hospital populations. Electronic supplementary material The online version of this article (doi:10.1186/s12917-016-0784-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shebl E Salem
- Institute of Infection and Global Health, Department of Epidemiology and Population Health, University of Liverpool, Wirral, CH64 7TE, UK.,Department of Surgery, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Chris J Proudman
- School of Veterinary Medicine, University of Surrey, Guildford, GU2 7TE, UK
| | - Debra C Archer
- Institute of Infection and Global Health, Department of Epidemiology and Population Health, University of Liverpool, Wirral, CH64 7TE, UK. .,Philip Leverhulme Equine Hospital, School of Veterinary Science, University of Liverpool, Wirral, CH64 7TE, UK.
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Duell JR, Thieman Mankin KM, Rochat MC, Regier PJ, Singh A, Luther JK, Mison MB, Leeman JJ, Budke CM. Frequency of Dehiscence in Hand-Sutured and Stapled Intestinal Anastomoses in Dogs. Vet Surg 2016; 45:100-3. [DOI: 10.1111/vsu.12428] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jason R. Duell
- Veterinary Clinical Sciences; Oklahoma State University; Stillwater Oklahoma
| | | | - Mark C. Rochat
- Veterinary Clinical Sciences; Oklahoma State University; Stillwater Oklahoma
| | - Penny J. Regier
- Veterinary Clinical Sciences; Oklahoma State University; Stillwater Oklahoma
| | - Ameet Singh
- Department of Clinical Studies, Ontario Veterinary College; University of Guelph; Guelph Ontario
| | - Jill K. Luther
- Midwest Veterinary Referral Center; Chesterfield Missouri
| | | | | | - Christine M. Budke
- Veterinary Integrative Biosciences; Texas A&M University, College Station; Texas
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17
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Salem SE, Proudman CJ, Archer DC. Prevention of post operative complications following surgical treatment of equine colic: Current evidence. Equine Vet J 2015; 48:143-51. [PMID: 26440916 DOI: 10.1111/evj.12517] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 09/29/2015] [Indexed: 11/28/2022]
Abstract
Changes in management of the surgical colic patient over the last 30 years have resulted in considerable improvement in post operative survival rates. However, post operative complications remain common and these impact negatively on horse welfare, probability of survival, return to previous use and the costs of treatment. Multiple studies have investigated risk factors for post operative complications following surgical management of colic and interventions that might be effective in reducing the likelihood of these occurring. The findings from these studies are frequently contradictory and the evidence for many interventions is lacking or inconclusive. This review discusses the current available evidence and identifies areas where further studies are necessary and factors that should be taken into consideration in study design.
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Affiliation(s)
- S E Salem
- Department of Surgery, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - C J Proudman
- Faculty of Health and Medical Sciences, School of Veterinary Medicine, Guildford, Surrey, UK
| | - D C Archer
- Institute of Infection and Global Health and School of Veterinary Sciences, University of Liverpool, Leahurst, Neston, UK
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Gandini M, Giusto G, Iotti B, Valazza A, Sammartano F. In vitro description of a new technique for stapled side-to-side jejunocecal anastomosis in horses and CT scan anatomical comparison with other techniques. BMC Vet Res 2014; 10 Suppl 1:S9. [PMID: 25238113 PMCID: PMC4122904 DOI: 10.1186/1746-6148-10-s1-s9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Stapled jejunocecal anastomoses are commonly performed in equine abdominal surgery. They carry higher complication rates compared to handsewn techniques. In human surgery various causes likely to lead to failure of stapled techniques have been evaluated, including staple line failure. Recently Freeman proposed a technique to perform a stapled jejunocecal anastomosis in horses while avoiding blind pouch formation. The aim of this study is to describe a method for stapled side-to-side jejunocecal anastomosis in horses and to compare it with other techniques with computed tomography to assess stomal area, shape and blind pouch size. Methods Intestinal specimens comprising the cecum, ileum and jejunum from 18 horses were collected and were divided into three groups. In Group S a standard stapled side-to-side jejunocecal anastomosis was performed. In Group F the anastomosis was performed using a modified technique proposed by Freeman. In Group G the anastomosis was performed with a modified technique proposed by the authors. Inflated bowel segments were CT scanned to obtain a MultiPlanar Reconstruction of the stoma and afferent small intestine before calculating the cross-sectional area of each of these regions. The ratio of the measured areas was compared between the three techniques. The volume of the blind-end pouch was measured and its ratio with the intestinal area compared between techniques. The cecum was opened and the length of the stoma measured with a caliper and compared to the intended initial length. Results The stomal/intestinal area ratio was not significantly different between techniques. No statistically significant difference was found in the stomal ideal/real perimeter ratio. There was no statistically significant difference in the intended/real stomal length ratio, and all techniques featured an increase in stomal length ranging from 2 to 12 %. Blind pouch formation was a consistent finding in Group S and was virtually absent in Groups F and G. Conclusions Both the Freeman and the new (G) technique were comparable to the standard technique in terms of stomal area, stomal shape and difference in stomal elongation. They consistently produced a smaller blind pouch and allowed easier placement of the staplers.
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Brown JA, Holcombe SJ, Southwood LL, Byron CR, Embertson RM, Hauptmann JG. End-to-Side Versus Side-to-Side Jejunocecostomy in Horses: A Retrospective Analysis of 150 Cases. Vet Surg 2014; 44:527-33. [DOI: 10.1111/j.1532-950x.2014.12256.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 06/01/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Jennifer A. Brown
- Marion DuPont Scott Equine Medical Center; Virginia-Maryland Regional College of Veterinary Medicine; Virginia Polytechnic and State University; Leesburg Virginia
| | - Susan J. Holcombe
- Department of Large Animal Clinical Sciences; College of Veterinary Medicine; Michigan State University; East Lansing Michigan
| | - Louise L. Southwood
- Department of Clinical Studies New Bolton Center; University of Pennsylvania; Kennett Square Pennsylvania
| | - Christopher R. Byron
- Department of Veterinary Clinical Medicine; College of Veterinary Medicine, University of Illinois; Urbana Illinois
| | | | - Joe G. Hauptmann
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; Michigan State University; East Lansing Michigan
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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; 43:451-8. [PMID: 24724591 DOI: 10.1111/j.1532-950x.2014.12188.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Accepted: 02/01/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare bursting strength, construction time, and anastomotic dimensions of 4 jejunoileal anastomotic techniques. STUDY DESIGN Experimental ex vivo study. ANIMALS Adult horses (n = 12). METHODS Jejunoileal anastomoses were constructed from harvested ileal and distal jejunal segments using a single-layer Lembert technique (1HS), double-layer simple continuous/Cushing technique (2HS), stapled side-to-side technique (SS), or stapled functional end-to-end technique (FEE). Anastomotic construction time was recorded. Bursting pressures (BP), bursting wall tension (BWT), percentage of mean anastomotic luminal diameter reduction, percentage of luminal diameter reduction relative to adjacent ileal and jejunal diameters and stomal length, were calculated. RESULTS FEE had the shortest construction time. BP of 1HS and 2HS was significantly higher than FEE and SS (P < .001), which were not different from each other (P = .67). There were no significant differences in BP (P = .25) and BWT (P = .21) between 1HS and 2HS. Mean luminal diameter reduction was less for 1HS (25.1%) than for 2HS (34.8%), however, not statistically different (P = .12). Luminal diameter reduction relative to ileal diameter was significantly less for 1HS (15.2%) than for 2HS (28.47%; P = .012). Luminal diameter reduction relative to jejunal diameter was less for 1HS (32.4%) than 2HS (44.6%) but not statistically different; P = .07). Stomal length was significantly larger for SS (9.93 cm) than FEE (7.32 cm; P = .0002). CONCLUSION 1HS and 2HS jejunoileal anastomosis are equal in strength; however, 1HS results in less relative luminal diameter reduction. SS and FEE have comparable strength but fail at significantly lower BPs than hand-sewn jejunoileal anastomoses.
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Affiliation(s)
- José L Bracamonte
- Department of Large Animal Clinical Sciences, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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21
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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; 43:471-8. [DOI: 10.1111/j.1532-950x.2014.12143.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2012] [Accepted: 06/01/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Kristyn Close
- College of Veterinary Medicine; Department of Large Animal Medicine; University of Georgia; Athens Georgia
| | - Kira L. Epstein
- College of Veterinary Medicine; Department of Large Animal Medicine; University of Georgia; Athens Georgia
| | - Ceri E. Sherlock
- College of Veterinary Medicine; Department of Large Animal Medicine; University of Georgia; Athens Georgia
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Freeman DE, Schaeffer DJ, Cleary OB. Long-term survival in horses with strangulating obstruction of the small intestine managed without resection. Equine Vet J 2014; 46:711-7. [PMID: 24237247 DOI: 10.1111/evj.12216] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 11/03/2013] [Indexed: 10/26/2022]
Abstract
REASONS FOR PERFORMING STUDY Although many studies have described results after small intestinal resection and anastomosis in horses, few have described the outcome in horses with strangulating lesions managed without resection. OBJECTIVES To examine short- and long-term recoveries in horses with strangulated small intestine that was judged to be viable during surgery and not resected. STUDY DESIGN Retrospective analysis of case records. METHODS Data were reviewed from all cases (35 horses) with colic caused by small intestinal strangulation that underwent surgery between 1996 and 2011 at 2 university hospitals and that were managed without resection by 2 surgeons who used a clinical grading system to assess intestinal viability. Kaplan-Meier analyses were used to examine long-term survival. RESULTS Survival to discharge from the hospital was 100%, and post operative complications developed in 11 horses (31%). Three horses (8.6%) required repeat coeliotomy because of persistent pain with or without reflux, and they responded favourably to decompression of distended intestine. Ten horses died after discharge, and 12 were still alive at follow-up from 20 to 192 months after surgery. Information was available on 13 horses after discharge, but these were eventually lost to follow-up. Kaplan-Meier analyses yielded a median survival probability of 120 months. CONCLUSIONS A subjective method of assessing small intestinal viability in strangulated small intestine in horses, as used in this study, could reduce the need for resection and anastomosis, with the associated complications and costs. Also, the favourable post operative course in these horses provides strong evidence that early referral could avoid the need for resection and improve survival. The numbers of horses with the most severe changes that were not resected were too small to allow a conclusion that such segments should be left in place, and additional criteria might be needed to guide that decision in such cases.
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Affiliation(s)
- D E Freeman
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, USA
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Ex Vivo Anatomical Characterization of Handsewn or Stapled Jejunocecal Anastomosis in Horses by Computed Tomography Scan. J Vet Med 2014; 2014:234738. [PMID: 26464922 PMCID: PMC4590882 DOI: 10.1155/2014/234738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 11/17/2014] [Indexed: 11/18/2022] Open
Abstract
The aim of this study is to compare handsewn and stapled jejunocecal anastomosis with different stomal lengths in terms of anatomical differences. Group 1 underwent a two-layer handsewn jejunocecal side-to-side anastomosis (HS); Group 2 received a stapled jejunocecal side-to-side anastomosis (GIA). Each group was divided into two subgroups (HS80 and HS100, GIA80 and GIA100). Specimens were inflated and CT scanned. The stomal/jejunal area ratio and blind end pouch volume/area were measured and compared. Effective length of the stoma was measured and compared with the initial length. Stomal/jejunal area ratio was 1.1 for both 80 techniques, 1.6 for the GIA100, and 1.9 for the HS100 technique. Both HS and GIA techniques produced a blind end pouch and exhibited a mean increase of the final stomal length ranging from 6 to 11% greater than the original stomal length. All techniques will exhibit a length increase of the final stomal length compared to the intended stomal length, with a consequent increase in stomal area. Stapled techniques consistently produced a large distal blind end pouch. Length of a jejunocecal anastomosis should be selected in accordance with the diameter of afferent jejunum, and the 80 mm stomal length could be deemed sufficient in horses.
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Stewart S, Southwood LL, Aceto HW. Comparison of short- and long-term complications and survival following jejunojejunostomy, jejunoileostomy and jejunocaecostomy in 112 horses: 2005-2010. Equine Vet J 2013; 46:333-8. [DOI: 10.1111/evj.12143] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 07/09/2013] [Indexed: 11/30/2022]
Affiliation(s)
- S. Stewart
- Department of Clinical Studies; New Bolton Center; School of Veterinary Medicine; University of Pennsylvania; USA
| | - L. L. Southwood
- Department of Clinical Studies; New Bolton Center; School of Veterinary Medicine; University of Pennsylvania; USA
| | - H. W. Aceto
- Department of Clinical Studies; New Bolton Center; School of Veterinary Medicine; University of Pennsylvania; USA
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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; 41:589-93. [PMID: 22731983 DOI: 10.1111/j.1532-950x.2012.00997.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To compare in vitro physical and mechanical characteristics of 1-layer and 2-layer end-to-end jejunoileostomy. STUDY DESIGN In vitro experimental study. ANIMALS 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.
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Affiliation(s)
- Wesley L Lee
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia Athens, GA 30602, USA
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26
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Freeman DE. The contribution of Barrie Edwards to the treatment of colic in the horse: an international perspective. Equine Vet J 2012; 44:127-9. [PMID: 22309252 DOI: 10.1111/j.2042-3306.2012.00548.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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FREEMAN DE, SCHAEFFER DJ. Clinical comparison between a continuous Lembert pattern wrapped in a carboxymethylcellulose and hyaluronate membrane with an interrupted Lembert pattern for one-layer jejunojejunostomy in horses. Equine Vet J 2011; 43:708-13. [DOI: 10.1111/j.2042-3306.2010.00340.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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SHERLOCK C, LEE W, MUELLER POE, EGGLESTON R, EPSTEIN K. Ex vivo comparison of three hand sewn end-to-end anastomoses in normal equine jejunum. Equine Vet J 2011:76-80. [DOI: 10.1111/j.2042-3306.2011.00423.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Freeman DE, Schaeffer DJ. Comparison of complications and long-term survival rates following hand-sewn versus stapled side-to-side jejunocecostomy in horses with colic. J Am Vet Med Assoc 2010; 237:1060-7. [DOI: 10.2460/javma.237.9.1060] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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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; 167:652-5. [DOI: 10.1136/vr.c5251] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- J. L. Mendez-Angulo
- Galbreath Equine Trauma; Intensive Care and Research Center; Veterinary Teaching Hospital; Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Ohio State University; 601 Vernon L. Tharp Street Columbus OH 43210 USA
| | - N. S. Ernst
- Galbreath Equine Trauma; Intensive Care and Research Center; Veterinary Teaching Hospital; Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Ohio State University; 601 Vernon L. Tharp Street Columbus OH 43210 USA
| | - M. C. Mudge
- Galbreath Equine Trauma; Intensive Care and Research Center; Veterinary Teaching Hospital; Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Ohio State University; 601 Vernon L. Tharp Street Columbus OH 43210 USA
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Abstract
In recent years important advancements in colic surgery have led to improved prediction of survival rates, better survival rates, and decreased complication rates. This article describes several modalities to combat and prevent incisional hernia and intestinal adhesion formation in horses undergoing colic surgery. These modalities have had a positive impact on reducing complications in horses after surgery.
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Affiliation(s)
- Gal Kelmer
- Large Animal Department, Koret Veterinary Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel.
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HOLCOMBE SUSANJ, RODRIGUEZ KATIEM, HAUPT JENNIFERL, CAMPBELL JAMESO, CHANEY KRISTINP, SPARKS HOLLYD, HAUPTMAN JOEG. Prevalence of and Risk Factors for Postoperative Ileus after Small Intestinal Surgery in Two Hundred and Thirty-Three Horses. Vet Surg 2009; 38:368-72. [DOI: 10.1111/j.1532-950x.2008.00479.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Hackett ES, Hassel DM. Colic: Nonsurgical Complications. Vet Clin North Am Equine Pract 2008; 24:535-55, viii. [DOI: 10.1016/j.cveq.2008.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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35
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Correspondence. Equine Vet J 2007. [DOI: 10.1111/j.2042-3306.2007.tb01002.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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