Symm William A, Nieto Jorge E, Van Hoogmoed Linda, Snyder Jack R
Veterinary Medical Teaching Hospital and the Department of Surgical and Radiological Sciences, Comparative Gastroenterology Laboratory, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA.
Vet Surg. 2006 Oct;35(7):674-7. doi: 10.1111/j.1532-950X.2006.00207.x.
To describe a novel stapling technique for creation of a complete cecal bypass, without ileal transection in horses.
Experimental study.
Four adult horses.
Through a ventral median celiotomy, jejunocolostomy was made with an intraluminal anastomosis device (ILA-100) and oversewn with a Cushing pattern to reinforce the staple line. Immediately distal to the anastomosis, 4 rows of staples were applied using a thoracoabdominal stapling device (TA-90) to occlude the lumen of the distal jejunum and proximal ileum. Necropsy exams were performed at least 60 days after surgery.
No intraoperative complications occurred. Cecal bypass was functional in all horses at necropsy. The most oral staple line across the ileum partially failed in 1 horse; however cecal bypass was functional.
Complete cecal bypass without ileal transection is a viable alternative to traditional methods of complete cecal bypass. Two sets of staple lines across the ileum are recommended. Longer term follow-up is warranted before clinical use of this technique.
Cecal bypass without ileal transection is technically simple and effectively bypasses the cecum. It also should intuitively require less time and have a reduced risk of contamination compared with complete cecal bypass with ileal transection.
描述一种用于马匹创建完整盲肠旁路且不切断回肠的新型吻合技术。
实验研究。
4匹成年马。
通过腹正中剖腹术，使用腔内吻合装置（ILA - 100）进行空肠结肠吻合，并采用库欣缝合法缝合以加固吻合钉线。在吻合口远侧立即使用胸腹吻合器（TA - 90）施加4排吻合钉，以封闭空肠远侧和回肠近侧的肠腔。术后至少60天进行尸检。
术中无并发症发生。尸检时所有马匹的盲肠旁路均功能正常。1匹马中横跨回肠的最靠近口腔端的吻合钉线部分失效；然而盲肠旁路仍功能正常。
不切断回肠的完整盲肠旁路是传统完整盲肠旁路方法的一种可行替代方案。建议在回肠上设置两组吻合钉线。在临床应用该技术之前，有必要进行更长时间的随访。
不切断回肠的盲肠旁路技术操作简单，能有效绕过盲肠。与切断回肠的完整盲肠旁路相比，直观上它所需时间更少，污染风险降低。
