Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.
Department of Statistics, College of Liberal Arts and Sciences University of Florida, Gainesville, Florida, USA.
Vet Surg. 2024 Feb;53(2):384-394. doi: 10.1111/vsu.14043. Epub 2023 Oct 17.
To compare time to construct completion and resistance to leakage for five intestinal anastomosis techniques in cats and to report normal feline gastrointestinal thickness.
Experimental study.
Grossly normal intestinal segments (n = 120) from 10 fresh cat cadavers.
A total of 8 cm segments of fresh feline cadaveric intestine were collected, and mural thickness was recorded. Segments were randomly allocated between a control group (n = 20 segments) and five treatment groups (20 segments/group with 2 segments/construct = 10 constructs per group): (1) hand-sewn anastomosis - simple interrupted (HSA-SI), (2) hand-sewn anastomosis - simple continuous (HSA-SC), (3) functional end-to-end stapled anastomosis (FEESA), (4) functional end-to-end stapled anastomosis with oversew (FEESA-O), (5) skin stapled anastomosis (SS). Time to construct completion, leakage location, initial leak pressure (ILP), and maximum intraluminal pressure (MIP) were compared.
Mean mural thickness ± SD (mm) for the stomach, duodenum, jejunum, and ileum were 1.66 ± 0.28, 2.05 ± 0.18, 2.28 ± 0.30, and 2.11 ± 0.39, respectively. ILPs (mean ± SD) for HSA-SI (165 ± 122 mmHg), HSA-SC (149 ± 83), FEESA-O (63 ± 25, FEESA (84 ± 59), SS (77 ± 56), and control segments (>500) were compared. There was no statistically significant difference in ILP (p > .08) or MIP (p > .084) between any treatment groups. Nonoversewn FEESAs were 2.4 times faster to perform compared to oversewn FEESA and SS groups, and 4.7 times faster than HSA (p < .001).
All anastomosis techniques provide resistance to leakage that is supraphysiological to that of the normal maximum intraluminal pressure. HSA take longer to complete than stapled anastomoses.
All anastomotic techniques may be appropriate in cats. Hand-sewn anastomoses result in a longer surgical time.
比较五种猫肠吻合技术的完成时间和抗渗漏能力，并报告正常猫的胃肠道厚度。
实验研究。
10 具新鲜猫尸体的大体正常肠段（n=120）。
共收集 8cm 长的新鲜猫尸体肠段，记录肠壁厚度。将肠段随机分配到对照组（n=20 段）和 5 个治疗组（每组 20 段/吻合术=每组 10 个吻合术）：（1）手工缝合吻合术-简单间断（HSA-SI），（2）手工缝合吻合术-简单连续（HSA-SC），（3）功能端端吻合钉合术（FEESA），（4）功能端端吻合钉合术加缝合（FEESA-O），（5）皮肤吻合钉合术（SS）。比较完成吻合术的时间、渗漏部位、初始漏压（ILP）和最大腔内压力（MIP）。
胃、十二指肠、空肠和回肠的平均壁厚度（mm）分别为 1.66±0.28、2.05±0.18、2.28±0.30 和 2.11±0.39。HSA-SI（165±122mmHg）、HSA-SC（149±83）、FEESA-O（63±25mmHg）、FEESA（84±59mmHg）、SS（77±56mmHg）和对照组（>500mmHg）的 ILP 平均值（±SD）。各组间 ILP（p>.08）或 MIP（p>.084）差异无统计学意义。非缝合 FEESAs 比缝合 FEESA 和 SS 组完成吻合术的速度快 2.4 倍，比 HSA 快 4.7 倍（p<.001）。
所有吻合技术的抗渗漏能力均高于正常最大腔内压力，均能抵抗渗漏。HSA 完成吻合术所需时间长于吻合钉合术。
所有吻合技术在猫中可能都是合适的。手工吻合术导致手术时间更长。
