Evaluation of the Effect of Onlay Mesenteric Flaps on End-To-End Jejunojejunostomy Healing in Horses

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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 (n = 6).

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 5 m 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 (P = .05), increased length of reduced peristomal jejunal diameter (P = .05), surgical time (P = .003), and serosal fibrosis (P = .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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