Evaluation of the effect of onlay mesenteric flaps on end-to-end jejunojejunostomy healing in horses
Date
2014
Authors
Aristizabal, F.A.
Lopes, M.A.
Silva, A.
Avanza, M.F.
Nieto, J.E.
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Journal article
Citation
Veterinary Surgery, 2014; 43(4):479-486
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Fabio A. Aristizabal, Marco Aurélio Lopes, Adriana Silva, Marcel Ferreira Avanza and Jorge E. Nieto
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Abstract
Objective: To evaluate the effect of onlay mesenteric flaps (MFs) with end‐to‐end jejunojejunostomy on stomal diameter, length of jejunum with reduced stomal diameter, abdominal adhesion formation, and healing. Study Design: Experimental study. Animals: Healthy adult horses (n¼6). Methods: Two hand sewn end‐to‐end jejunal anastomoses using a 1 layer simple continuous serosubmucosal suture pattern were performed in each horse ∼2 and 5m oral to the ileocecal fold. Using a random design for selection anastomosis location (oral or aboral), 1 anastomosis was covered with 2 adjacent onlay MFs secured with interrupted sutures and cyanoacrylate glue. Two weeks later, adhesion formation, stomal diameter, length of reduced jejunal stomal diameter, and healing were evaluated. Results: Use of onlay MFs decreased stomal diameter (P¼.05), increased length of reduced peristomal jejunal diameter (P¼.05), surgical time (P¼.003), and serosal fibrosis (P¼.05). No difference was evident for adhesion formation, and degree of inflammation between techniques. Conclusion: End‐to‐end jejunojejunostomy covered with 2 onlay MFs is not recommended because this technique results in luminal reduction.
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© Copyright 2014 by The American College of Veterinary Surgeons