Department of Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA.
Veterinary Administration, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA.
Vet Surg. 2022 Jul;51(5):801-808. doi: 10.1111/vsu.13827. Epub 2022 May 25.
To evaluate the influence of barbed suture oversew of the transverse staple line during functional end-to-end stapled anastomosis (FEESA) in dogs.
Randomized, experimental, ex vivo.
Grossly normal jejunal segments from 14 adult canine cadavers.
Ninety-eight jejunal segments (n = 14/FEESA group, n = 14 controls) were harvested and randomly assigned to a control group, FEESA + monofilament suture oversew, FEESA + unidirectional barbed suture oversew or FEESA + bidirectional barbed suture oversew. Oversew techniques were performed using a Cushing suture pattern. Initial (ILP) and maximum leakage pressure (MLP), repair time (s), and location of observed leakage were recorded.
No differences were detected in ILP (p = .439) or MLP (p = .644) respectively between experimental groups. Repairs times using barbed suture were ~ 18% faster (~25 s faster; p < .001) compared to monofilament suture. There was no difference between barbed suture types (p = .697). Mean ILP (p < .001) and MLP (p < .0001) were 6.6x and 5.1x greater respectively in the control group. Leakage location occurred predominately at the crotch of the FEESA in all groups.
FEESAs closed with a transverse staple line oversew using barbed suture, regardless of barb orientation, were completed faster and resulted in similar resistance to anastomotic leakage compared to monofilament suture.
Oversewing the transverse staple line following FEESA using barbed suture offers similar resistance to anastomotic leakage, and may be associated with decreased surgical times in dogs compared to monofilament suture. Further studies are necessary to determine the benefits of barbed suture use in both open and laparoscopic gastrointestinal surgical applications following FEESA in dogs.
评估在犬功能性端端吻合（FEESA）中使用带刺缝线横向缝合线的影响。
随机、实验、离体。
14 具成年犬尸体的大体正常空肠段。
共采集 98 个空肠段（n=14/FEESA 组，n=14 对照组），并随机分为对照组、FEESA+单丝缝线缝合、FEESA+单向带刺缝线缝合或 FEESA+双向带刺缝线缝合。缝合技术采用 Cushing 缝线模式。记录初始漏液压力（ILP）和最大漏液压力（MLP）、修复时间（s）和观察到的漏液位置。
各组之间的 ILP（p=0.439）或 MLP（p=0.644）均无差异。与单丝缝线相比，使用带刺缝线的修复时间快约 18%（快约 25s；p<0.001）。两种带刺缝线类型之间无差异（p=0.697）。对照组的平均 ILP（p<0.001）和 MLP（p<0.0001）分别增加了 6.6 倍和 5.1 倍。在所有组中，漏液位置均主要发生在 FEESA 的分叉处。
FEESA 采用横向吻合线带刺缝线缝合，无论刺方向如何，都能更快地完成，与单丝缝线相比，吻合口漏液的阻力相似。
FEESA 后使用带刺缝线横向缝合吻合线可以提供相似的吻合口漏液阻力，并且与单丝缝线相比，可能与犬的手术时间缩短有关。进一步的研究有必要确定在犬的 FEESA 后，无论是在开放还是腹腔镜胃肠道手术应用中，使用带刺缝线的益处。
