Comparison of One‐Layer (Continuous Lembert) Versus Two‐Layer (Simple Continuous/Cushing) Hand‐Sewn End‐to‐End Anastomosis in Equine Jejunum

Nieto, Jorge E.; Dechant, Julie E.; Snyder, Jack R.

doi:10.1111/j.1532-950x.2006.00206.x

Cited by 40 publications

(123 citation statements)

References 14 publications

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“…The Lembert pattern is commonly known to result in more suture material exposure when performing intestinal anastomosis (Nieto and others 2006), which was confirmed in the present study. It therefore performed poorly in cosmetic grading both before and after cooking.…”

Section: Discussionsupporting

confidence: 87%

Investigation of the best suture pattern to close a stuffed Christmas turkey

et al. 2011

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Instructions on how to debone and stuff a turkey are available, but what is the best way to close it up? A randomised trial involving 15 turkeys was performed in order to evaluate skin disruption scores and cosmetic outcomes following the use of different suture patterns. Turkeys were deboned, stuffed and cooked according to guidelines of the US Department of Agriculture Food Safety and Inspection Services. After stuffing, they were randomly assigned to one of five closure groups: simple continuous Lembert; simple continuous Cushing; simple continuous Utrecht; simple continuous; or staples. Turkeys were cooked at 180°C for two hours ensuring core temperature reached 75°C. Suture line integrity was evaluated after removal of the sutures and the cosmetic aspect was graded. Before cooking, the Utrecht pattern and skin staples offered the best cosmetic result. After removal of the sutures, the skin remained intact only in the stapled group. All other suture patterns disrupted the skin after removal of the sutures, rendering the turkey less cosmetically appealing for serving. Closure of a stuffed turkey was best performed using skin staples to achieve the best cosmetic results. Using this technique you will be able to impress family and friends at a Christmas dinner, and finally show them your surgical skills.

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Section: Discussionsupporting

confidence: 87%

Investigation of the best suture pattern to close a stuffed Christmas turkey

et al. 2011

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“…A reduction in anastomotic size from control lumen by 15–44.6% in small intestinal anastomoses (median = 28% reduction; Fig ) appears to be regarded by some surgeons as acceptable for an end‐to‐end anastomosis, based on data from recent cadaver studies (Gandini ; Gandini and Bertuglia ; Nieto et al . ; Sherlock et al . ; Lee et al .…”

Section: Role Of Surgerymentioning

confidence: 99%

Post‐operative reflux – a surgeon's perspective

Freeman

2017

Equine Veterinary Education

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Summary Post‐operative ileus (POI) is a well‐recognised complication of colic surgery that accounts for a high proportion of post‐operative deaths. Although much has been written about the pathophysiology and management of POI in horses, most studies seem to apply research findings to the clinical case without full regard for the clinical evidence. Although much attention has focused recently on the role of inflammation, this narrow focus might explain our failure to make important advances in managing horses with this complication. This commentary is offered to redirect our current thinking about POI away from an approach that predominantly emphasises a functional disorder and medical management, to one that addresses surgical prevention.

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“…Anastomosis quality was assessed by the following parameters: endoluminal and extraluminal macroscopic appearance of the anastomotic line, perianastomotic adhesion density, the bursting pressure of the anastomoses, and histological changes during the healing phases. There have been numerous clinical and experimental studies on surgical techniques and the healing process of intestinal anastomosis [1–3, 10]. Traditionally, surgical sutures have been used to perform manual intestinal anastomoses which are mainly made by staplers, and training of surgeons in manual anastomosing is still very much needed.…”

Section: Discussionmentioning

confidence: 99%

“…Traditionally, surgical sutures have been used to perform manual intestinal anastomoses which are mainly made by staplers, and training of surgeons in manual anastomosing is still very much needed. There are different preferences among surgeons regarding the use of surgical techniques for creating intestinal anastomoses [3, 11]. …”

Section: Discussionmentioning

confidence: 99%

“…There is still interest in research on intestinal anastomosis because failed anastomosis is associated with high morbidity and mortality [1]. Although manual intestinal anastomosis has been practiced for centuries, it is still considered as an option among the preferred types of anastomotic techniques [2, 3]. Anastomotic technique is an important part of successful anastomosis healing [4].…”

Section: Introductionmentioning

confidence: 99%

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A Comparison of Two Anastomotic Techniques in the Jejunum of the Goat

Al-Timmemi

Al-Jashamy

Dauod

2010

Veterinary Medicine International

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This study was carried out to test two different anastomotic techniques to identify advantages and disadvantages of each technique in goats. All animals were under local infiltration anaesthesia. A five-cm length of jejunum was resected from the first part of the jejunum and end to end anastomosis using 3-0 Polygalactin-910 with one row of sero-submoucosal interrupted sutures (SSIS) group, and one row of horizontal mattress interrupted sutures (HMIS) group. Two animals from each group were euthanized on the 4th, 14th and 21st postoperative days. A 7-cm segment of jejunum including the anastomosed area was resected from each animal. There was no significant adhesion between anastomosis area and surrounded tissues observed in SSIS animals, while there was significant adhesion between anastomosis area and surrounded tissues which were observed in HMIS animals. Stenosis degree was lower in the SSIS than the HMIS group. The bursting pressure was higher in the SSIS than the HMIS group. Macroscopic evaluation indicated that the anastomotic line mucosa was abridged better with less local edema in the SSIS group. Histological evaluation in the SSIS group showed almost all parameters such as epithelial recovery and repair of submucosal-mucosal layer demonstrated better healing compared to the HMIS group.

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Comparison of One‐Layer (Continuous Lembert) Versus Two‐Layer (Simple Continuous/Cushing) Hand‐Sewn End‐to‐End Anastomosis in Equine Jejunum

Abstract: Use of a 1-layer continuous Lembert pattern for jejunojejunosotomy may be beneficial by decreasing anastomosis time and produce a larger stoma than a 2-layer anastomosis.

Cited by 40 publications

References 14 publications

Investigation of the best suture pattern to close a stuffed Christmas turkey

Investigation of the best suture pattern to close a stuffed Christmas turkey

Post‐operative reflux – a surgeon's perspective

A Comparison of Two Anastomotic Techniques in the Jejunum of the Goat

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