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Intraoperative surgeon probe inspection compared to leak testing for detecting gaps in canine jejunal continuous anastomoses: A cadaveric study
Author(s) -
Culbertson Tricia F.,
Smeak Daniel D.,
Pogue Joanna M.,
Vitt Molly A.,
Downey Amy C.
Publication year - 2021
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.13708
Subject(s) - medicine , anastomosis , cadaveric spasm , leak , cadaver , fibrous joint , surgery , nuclear medicine , environmental engineering , engineering
Objective To compare the detection of gaps in jejunal continuous anastomoses by probing (PT) versus leak testing (LT). Study Design Experimental study. Animals Normal jejunal segments (n = 24) from two fresh canine cadavers. Methods Intestinal segments were randomly selected by four volunteers who created six simple continuous anastomoses: two constructs using standard technique with 2–3 mm suture spacing (ST, 8 total), and four constructs with one 4‐mm gap (IG, 16 total). All 24 anastomoses were examined with PT (1 volunteer) prior to LT (3 volunteers). LT was performed within a maximal peristaltic pressure range (34–54 cmH 2 O). The presence and location of anastomotic leaks (L A ) detected with LT were compared with gaps detected with PT. Results Nineteen out of twenty‐four (79.2%) samples had at least one probe drop, and four out of twenty‐three (17.4%) samples leaked. LT results from one sample were excluded due to iatrogenic suture failure. PT was 100% sensitive (95% CI: 51.01, 100%) with a 100% negative predictive value (95% CI: 56.55, 100%) at detecting gaps compared with LT. The location of all L A was accurately identified with PT and confirmed during LT. Conclusion PT was highly sensitive at detecting gaps compared with LT. All L A were accurately detected by PT. None of the segments negative during PT leaked. Clinical Significance The diagnostic value of PT appears adequate to recognize gaps in cadaveric small intestinal anastomoses. PT offers surgeons an alternative to detect suture gaps that may contribute to postoperative dehiscence of intestinal anastomoses.