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Gastrointestinal thickness, duration, and leak pressure of six intestinal anastomoses in dogs
Author(s) -
Mullen Kaitlyn M.,
Regier Penny J.,
Waln Monica,
FoxAlvarez W. Alexander,
Colee James
Publication year - 2020
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/vsu.13490
Subject(s) - anastomosis , medicine , jejunum , leak , ileum , cadaveric spasm , duodenum , peristalsis , surgery , anatomy , environmental engineering , engineering
Objective To compare leak pressures and construct completion time of six intestinal anastomoses and report normal canine gastrointestinal thickness. Study design Experimental study. Animals Grossly normal jejunal segments (n = 140) from 10 fresh canine cadavers. Methods Gastrointestinal thickness was recorded. Eight‐centimeter cooled canine cadaveric jejunal segments were randomly assigned to a control group (20 segments) and six treatment groups (20 segments/group [10 constructs/group]): (1) handsewn anastomosis (HSA), (2) functional end‐to‐end stapled anastomosis (FEESA)‐blue thoracoabdominal (TA; FEESA‐TAB), (3) FEESA‐green TA (FEESA‐TAG), (4) FEESA TA‐gastrointestinal anastomosis (GIA), (5) FEESA with suture oversew (FEESA‐O), and (6) skin staples (SS). Construct assembly time, initial leak pressure (ILP), maximum intraluminal pressure (MIP), and leakage location were compared. Results Initial leak pressures (mean ± SD) for control (308.38 ± 115.91 mm Hg), HSA (41.96 ± 15.97), FEESA‐TAB (31.71 ± 15.71), FEESA‐TAG (27.24 ± 14.11), FEESA‐GIA (25.62 ± 11.22), FEESA‐O (31.01 ± 17.38), and SS (44.42 ± 28.88) groups were compared. No difference in ILP ( P > .24) or MIP ( P > .17) was detected between treatment groups. Sutured anastomoses took up to 10 times longer to complete ( P = .0025). The stomach, duodenum, jejunum, and ileum mural thicknesses (mean ± SD) were 3.99 ± 0.44 mm, 2.34 ± 0.16, 2.49 ± 0.28, and 2.30 ± 0.31, respectively. Conclusion The ILP of all anastomoses exceeded maximum intraluminal peristaltic pressures. Stapled anastomoses were faster to complete. Clinical significance All anastomoses may be considered when performing an intestinal resection and anastomosis, with stapled anastomoses resulting in a shorter surgical time. Canine intestinal thickness may warrant use of a larger staple size.