Sherlock C, Lee W, Mueller P O E, Eggleston R, Epstein K
College of Veterinary Medicine, Department of Large Animal Medicine, The University of Georgia, GA, USA.
Equine Vet J Suppl. 2011 Aug(39):76-80. doi: 10.1111/j.2042-3306.2011.00423.x.
Although single layer techniques are preferred in man and small animals for small intestinal end-to-end anastomoses, double layer techniques are more popular in equine surgery. This study was undertaken to evaluate the ex vivo characteristics of 2 single layer anastomoses in comparison to the traditionally performed double layer anastomosis in equine jejunum.
To compare ex vivo: 1) construction time; 2) bursting pressure; and 3) lumen size reduction of 3 suture patterns (double layer simple continuous/Cushing pattern [2C]; single layer Lembert pattern [1L]; and single layer Cushing pattern [1C]) for end-to-end equine jejunojejunostomies.
End-to-end jejunojejunostomies were constructed using 2C (n = 7), 1L (n = 7) and 1C (n = 7) in harvested equine jejunum and construction times were recorded. Anastomosed and control segments were distended with gas until failure. Intraluminal pressure at failure and mode of failure were recorded. Lumen size reduction was calculated as a percentage decrease from control jejunum. Results were compared using an ANOVA and P<0.05 was considered significant.
The 1C anastomoses were faster to construct than the 1L anastomoses, which were faster to construct than the 2C anastomoses. There were no differences in bursting pressures between the different anastomoses and control jejunum. All anastomoses decreased lumen size from control values but there were no differences in lumen reduction between types of anastomoses.
Single layer anastomoses are faster to construct than double layer anastomoses, with the 1C being fastest. Single layer anastomoses are as strong and result in comparable lumen size reduction as traditional 2C anastomoses.
As the 1C anastomosis results in less exposed potentially adhesiogenic suture material than the 1L while providing adequate strength and similar luminal size reduction, the 1C may be better for equine small intestine anastomosis and further in vivo studies are warranted.
尽管在人和小型动物的小肠端端吻合术中单层技术更为可取，但双层技术在马外科手术中更受欢迎。本研究旨在评估两种单层吻合术与传统双层吻合术相比在马空肠中的体外特性。
在体外比较3种缝合方式（双层单纯连续/库欣缝合法[2C]；单层伦伯特缝合法[1L]；单层库欣缝合法[1C]）用于马端端空肠吻合术的：1）构建时间；2）破裂压力；3）管腔尺寸减小情况。
在采集的马空肠中使用2C（n = 7）、1L（n = 7）和1C（n = 7）构建端端空肠吻合术，并记录构建时间。用气体扩张吻合段和对照段直至破裂。记录破裂时的腔内压力和破裂模式。管腔尺寸减小以相对于对照空肠的百分比下降来计算。使用方差分析比较结果，P<0.05被认为具有显著性。
1C吻合术的构建速度比1L吻合术快，1L吻合术的构建速度比2C吻合术快。不同吻合术与对照空肠之间的破裂压力没有差异。所有吻合术均使管腔尺寸较对照值减小，但不同类型吻合术之间的管腔减小没有差异。
单层吻合术的构建速度比双层吻合术快，其中1C最快。单层吻合术与传统的2C吻合术一样牢固，且管腔尺寸减小情况相当。
由于1C吻合术比1L吻合术暴露的潜在致粘连缝合材料更少，同时提供足够的强度和相似的管腔尺寸减小，1C可能更适合马小肠吻合术，有必要进一步开展体内研究。
