Rood and Riddle Equine Hospital, Wellington, Florida, USA.
Island Whirl Equine Colic Research Laboratory, Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.
Vet Surg. 2023 Apr;52(3):407-415. doi: 10.1111/vsu.13881. Epub 2022 Sep 9.
To compare single-layer anastomoses (modified continuous Lembert [mod-CL] and modified-interrupted Lembert [mod-IL]) and a 2-layer simple continuous anastomosis (2 L; seromuscular and mucosal) for jejunojejunal anastomoses in equine cadavers and to compare ex vivo to in vivo time to complete the anastomosis and stoma size with a mod-IL pattern.
Measurements in jejunum from cadaver and anesthetized horses.
Ten live horses and 18 equine cadavers.
Time to complete anastomosis, bursting pressures (BP), leakage sites, and anastomotic index (size ratio of anastomotic lumen to control lumen) were recorded. Time to completion and lumen size were compared between in vivo and ex vivo mod-IL patterns.
The mod-CL pattern was fastest (8.44 ± 1.30 min, p < .05), and the 2 L pattern was slower (17.07 ± 2.0 min) than the mod-CL and mod-IL (p < .05). The anastomotic index exceeded 100 and did not differ between patterns. Segments reached higher bursting pressures when anastomosed with mod-IL (145.94 ± 24.18 mm Hg) than mod-CL (p < .05). In vivo closure was approximately 8 minutes slower than ex vivo, and with a smaller anastomotic index.
All anastomoses increased lumen size over control segments ex vivo. Lumen size after placement of a mod-IL was greater ex vivo than in vivo, and completion was slower in vivo than ex vivo. [Corrections added on 26 Dec 2022, after online publication: added "ex vivo" to the first line of Conclusions in the Abstract.] CLINICAL SIGNIFICANCE: Slower and smaller anastomoses should be anticipated in vivo compared to ex vivo results. Anastomoses with a mod-IL pattern appear clinically advantageous, producing a comparable lumen size in less time than 2 L.
比较单层吻合（改良连续伦伯特[mod-CL]和改良间断伦伯特[mod-IL]）和双层简单连续吻合（2L；浆肌层和黏膜层）在马尸体中的空肠空肠吻合，并比较 mod-IL 模式的体外和体内吻合完成时间和造口大小。
尸体和麻醉马空肠的测量。
10 匹活马和 18 匹马尸体。
记录吻合完成时间、爆裂压（BP）、渗漏部位和吻合指数（吻合管腔与对照管腔的大小比）。比较体内和体外 mod-IL 模式的完成时间和管腔大小。
mod-CL 模式最快（8.44 ± 1.30 分钟，p <.05），2L 模式最慢（17.07 ± 2.0 分钟），明显快于 mod-CL 和 mod-IL（p <.05）。吻合指数超过 100，各模式之间无差异。吻合后 mod-IL 段达到较高的爆裂压（145.94 ± 24.18 毫米汞柱）高于 mod-CL（p <.05）。体内闭合速度比体外慢约 8 分钟，吻合指数较小。
所有吻合在体外均使管腔大小超过对照段。体外放置 mod-IL 后管腔大小大于体内，体内完成时间比体外慢。[2022 年 12 月 26 日在线出版后更正：在摘要的第一行“体外”中添加了“ex vivo”。]临床意义：与体外结果相比，体内吻合应预期较慢且较小。mod-IL 模式的吻合在较短的时间内产生可比的管腔大小，比 2L 更具临床优势。
