Evaluation of the Effect of Onlay Mesenteric Flaps on End‐To‐End Jejunojejunostomy Healing in Horses

• Published in: Veterinary surgery Vol. 43; no. 4; pp. 479 - 486
• Main Authors: Aristizabal, Fabio A, Lopes, Marco Aurélio, Silva, Adriana, Avanza, Marcel Ferreira, Nieto, Jorge E
• Format: Journal Article
• Language: English
• Published: United States Harcourt Health Sciences 01.05.2014; Blackwell Publishing Ltd
• Subjects: adhesion; Animals; Cell adhesion & migration; experimental design; Female; fibrosis; Horses; inflammation; Jejunostomy - methods; Jejunostomy - veterinary; jejunum; Male; Medical disorders; Mesentery - surgery; Postoperative Complications - pathology; Postoperative Complications - veterinary; Stomach; Surgical Flaps - veterinary; Suture Techniques - veterinary; sutures; Wound Healing - physiology
• ISSN: 0161-3499; 1532-950X
• DOI: 10.1111/j.1532-950X.2014.12120.x

OBJECTIVE: To evaluate the effect of onlay mesenteric flaps (MFs) with end‐to‐end jejunojejunostomy on stomal diameter, length of jejunum with reduced stomal diameter, abdominal adhesion formation, and healing. STUDY DESIGN: Experimental study. ANIMALS: Healthy adult horses (n = 6). METHODS: Two hand sewn end‐to‐end jejunal anastomoses using a 1 layer simple continuous serosubmucosal suture pattern were performed in each horse ∼2 and 5 m oral to the ileocecal fold. Using a random design for selection anastomosis location (oral or aboral), 1 anastomosis was covered with 2 adjacent onlay MFs secured with interrupted sutures and cyanoacrylate glue. Two weeks later, adhesion formation, stomal diameter, length of reduced jejunal stomal diameter, and healing were evaluated. RESULTS: Use of onlay MFs decreased stomal diameter (P = .05), increased length of reduced peristomal jejunal diameter (P = .05), surgical time (P = .003), and serosal fibrosis (P = .05). No difference was evident for adhesion formation, and degree of inflammation between techniques. CONCLUSION: End‐to‐end jejunojejunostomy covered with 2 onlay MFs is not recommended because this technique results in luminal reduction.