Gastrointestinal thickness, duration, and leak pressure of six intestinal anastomoses in dogs

Vet Surg. 2020 Oct;49(7):1315-1325. doi: 10.1111/vsu.13490. Epub 2020 Jul 22.

Abstract

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.

MeSH terms

  • Anastomosis, Surgical / veterinary*
  • Animals
  • Cadaver
  • Digestive System Surgical Procedures / methods
  • Digestive System Surgical Procedures / veterinary*
  • Dogs / surgery*
  • Jejunum / surgery*
  • Operative Time
  • Pressure
  • Suture Techniques / veterinary*
  • Sutures / veterinary