Bracamonte José L, Anderson Stacy L, Hendrick Steven, Barber Spencer M, Deutscher David, Sumner David
Department of Large Animal Clinical Sciences, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Vet Surg. 2014 May;43(4):451-8. doi: 10.1111/j.1532-950X.2014.12188.x. Epub 2014 Apr 11.
To compare bursting strength, construction time, and anastomotic dimensions of 4 jejunoileal anastomotic techniques.
Experimental ex vivo study.
Adult horses (n = 12).
Jejunoileal anastomoses were constructed from harvested ileal and distal jejunal segments using a single-layer Lembert technique (1HS), double-layer simple continuous/Cushing technique (2HS), stapled side-to-side technique (SS), or stapled functional end-to-end technique (FEE). Anastomotic construction time was recorded. Bursting pressures (BP), bursting wall tension (BWT), percentage of mean anastomotic luminal diameter reduction, percentage of luminal diameter reduction relative to adjacent ileal and jejunal diameters and stomal length, were calculated.
FEE had the shortest construction time. BP of 1HS and 2HS was significantly higher than FEE and SS (P < .001), which were not different from each other (P = .67). There were no significant differences in BP (P = .25) and BWT (P = .21) between 1HS and 2HS. Mean luminal diameter reduction was less for 1HS (25.1%) than for 2HS (34.8%), however, not statistically different (P = .12). Luminal diameter reduction relative to ileal diameter was significantly less for 1HS (15.2%) than for 2HS (28.47%; P = .012). Luminal diameter reduction relative to jejunal diameter was less for 1HS (32.4%) than 2HS (44.6%) but not statistically different; P = .07). Stomal length was significantly larger for SS (9.93 cm) than FEE (7.32 cm; P = .0002).
1HS and 2HS jejunoileal anastomosis are equal in strength; however, 1HS results in less relative luminal diameter reduction. SS and FEE have comparable strength but fail at significantly lower BPs than hand-sewn jejunoileal anastomoses.
比较4种空肠回肠吻合技术的抗破裂强度、构建时间和吻合口尺寸。
体外实验研究。
成年马（n = 12）。
使用单层伦伯特技术（1HS）、双层单纯连续/库欣技术（2HS）、吻合器侧侧吻合技术（SS）或吻合器功能性端端吻合技术（FEE），用采集的回肠段和空肠远端构建空肠回肠吻合口。记录吻合口构建时间。计算抗破裂压力（BP）、破裂壁张力（BWT）、平均吻合口管腔直径减小百分比、相对于相邻回肠和空肠直径的管腔直径减小百分比以及吻合口长度。
FEE的构建时间最短。1HS和2HS的BP显著高于FEE和SS（P < .001），FEE和SS之间无差异（P = .67）。1HS和2HS之间的BP（P = .25）和BWT（P = .21）无显著差异。1HS的平均管腔直径减小（25.1%）低于2HS（34.8%），但无统计学差异（P = .12）。相对于回肠直径，1HS的管腔直径减小（15.2%）显著低于2HS（28.47%；P = .012）。相对于空肠直径，1HS的管腔直径减小（32.4%）低于2HS（44.6%），但无统计学差异；P = .07）。SS的吻合口长度（9.93 cm）显著大于FEE（7.32 cm；P = .0002）。
1HS和2HS空肠回肠吻合术强度相当；然而，1HS导致的相对管腔直径减小较少。SS和FEE强度相当，但抗破裂压力显著低于手工缝合的空肠回肠吻合术。
