<i>Ex Vivo</i> Comparison of the Biomechanical Properties of Hand‐Sewn and Stapled Jejunoileal Anastomoses in Horses

Bracamonte, José L.; Anderson, Stacy; Hendrick, S.; Barber, Spencer M.; Deutscher, David; Sumner, D.

doi:10.1111/j.1532-950x.2014.12188.x

Cited by 10 publications

(42 citation statements)

References 32 publications

(145 reference statements)

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“…; Nelson and Hassel ; Bracamonte et al . ). Some of these reductions in lumen diameter approach or exceed the threshold 40% decrease in lumen diameter that reduces flow through human small intestine (Morel et al .…”

Section: Role Of Surgerymentioning

confidence: 97%

“…This difference was attributed to the complex design of a jejunocecostomy and poor tolerance for errors in its construction, compared with the simpler jejunojejunostomy (Freeman et al 2000). A reduction in anastomotic size from control lumen by 15-44.6% in small intestinal anastomoses (median = 28% reduction; Fig 6) appears to be regarded by some surgeons as acceptable for an end-to-end anastomosis, based on data from recent cadaver studies (Gandini 2006;Gandini and Bertuglia 2006;Nieto et al 2006;Sherlock et al 2011;Lee et al 2012;Nelson and Hassel 2014;Bracamonte et al 2014). Some of these reductions in lumen diameter approach or exceed the threshold 40% decrease in lumen diameter that reduces flow through human small intestine (Morel et al 1990).…”

Section: Role Of Surgerymentioning

confidence: 99%

“…App mucosa + App SM (Bauck 2015) App + cushing (Nieto 2006) SC mucosa + cushing (Bracamonte 2014) SC mucosa + cushing (Bracamonte 2014) SC mucosa + cushing (Lee 2012) SC mucosa + cushing (Sherlock 2011) Int Lembert (Bauck 2015) Cont Lembert (Bauck 2015) Cont Lembert (Nelson 2014) Cont Lembert (Nelson 2014) Cont Lembert (Bracamonte 2014) Cont Lembert (Lee 2012) Cushing (Sherlock 2011) Cont Lembert (Bracamonte 2014) Cont Lembert (Sherlock 2011) Cont Lembert (Nieto 2006) SC mucosa + cushing (Gandini 2006) SC mucosa + cushing (Gandini 2006a) Skin staples (Gandini 2006a) Closed (Gandini 2006 et al 1979). Consequently, the anastomosis must allow sufficient flow of contents through it to distend the distal segment and stimulate its motility.…”

Section: Role Of Surgerymentioning

confidence: 99%

“…Effects of different anastomoses in cadaver small intestine on lumen size relative to control segments, with lumen reduction to the left and lumen expansion to the right. Data obtained from recent cadaver studies(Gandini 2006;Gandini and Bertuglia 2006;Nieto et al 2006;Sherlock et al 2011;Lee et al 2012;Bracamonte et al 2014;Nelson and Hassel 2014; A.G. Bauck, D.E. Freeman, A.J.…”

mentioning

confidence: 99%

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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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Section: Role Of Surgerymentioning

confidence: 97%

Section: Role Of Surgerymentioning

confidence: 99%

Section: Role Of Surgerymentioning

confidence: 99%

mentioning

confidence: 99%

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Post‐operative reflux – a surgeon's perspective

Freeman

2017

Equine Veterinary Education

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“…The degree of inhibition of circular muscle contractility is related directly to the magnitude of leukocyte and macrophage infiltration, which in turn depends on the intensity of intestinal manipulation; therefore, every effort should be made to reduce intestinal trauma. One surgical method able to reduce surgery time is the use of the stapled technique for jejunal resections [117]. As already described above, other postoperative complications in horses undergoing abdominal surgeries have an impact in developing POI, notably by postanesthetic myopathy [118,119].…”

Section: Intraoperative Strategies In the Prevention Of Equine Poimentioning

confidence: 99%

Current Strategies for Prevention and Treatment of Equine Postoperative Ileus: A Multimodal Approach

Kovač́¹,

Aliev²,

Pozyabin³

et al. 2020

Equine Science

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Equine paralytic (postoperative) ileus generally refers to an acute condition of impaired gastrointestinal motility. Paralytic ileus is most frequently seen following abdominal surgery on the small intestine in horses. Three main mechanisms are involved separately or simultaneously in its causation, namely neurogenicendocrinic, inflammatory-endotoxic and pharmacological mechanisms. Regardless of the cause, equine paralytic ileus can be fatal, if not properly diagnosed and treated. Over the past 22 years (1997-2019), we have diagnosed and treated more than 180 horses with postoperative ileus using differing methods. Based on our results and experience, and that of others, we have developed a multimodal strategy to reduce the incidence of postoperative ileus. This has resulted in effective treatment of ileus-diagnosed patients in 94% of cases, a significant improvement in survival rates over the last 20 years. In this review, we described pre-, intra-, and postoperative multiple supplementary preventative and treatment procedures that cure this condition. These methods are dependent on individual cases but include the control of endotoxemia and inflammation, as well as using the least traumatic surgical techniques, carrying out the pelvic flexure colotomy, improved anesthesia techniques, treating with continuous postoperative peritoneal lavage, the use of fluid, antibiotic and NSAIDs therapy, according to a scheme the use of different prokinetic agents (including metoclopramide, neostigmine methylsulfate and domperidone), nasogastric decompression, management to minimize the surgical and postoperative stress reaction and judicious timing of postoperative feeding of horses.An appreciation of the basic mechanisms that regulate gastrointestinal motility is a key component to understanding paralytic ileus. The musculature of the gastrointestinal tract in horses is made up of smooth muscle cells that are intimately associated, thus allowing them to conduct electrophysiological functions. There are three distinctive electrical potentials in the equine intestine: resting potential, slow-wave and spike potential that trigger contractions. Slow waves are rhythmic pacemaker currents initiated by the interstitial cells of Cajal (ICC). Normal gastrointestinal motility in horses results from very complex interactions among the enteric nervous system (ENS), autonomic and central nervous systems, ICC, gastrointestinal hormones, immune cells, glial cells and local factors that affect smooth-muscle activity [21,[23][24][25]. Extrinsically, the sympathetic nervous input through noradrenaline has an inhibitory effect on gastrointestinal motility, whereas parasympathetic input increases motility. The ENS is involved in all aspects of gastrointestinal function, not only motility, as well as by enteric processes such as immune responses, detecting nutrients, microvascular circulation, intestinal barrier function, and epithelial secretion of fluids and ions [10]. The neurons of the ENS are collected into two types of ganglia: myenteric (...

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Jejunum and Ileum

Freeman¹

2019

Equine Surgery

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Ex Vivo Comparison of the Biomechanical Properties of Hand‐Sewn and Stapled Jejunoileal Anastomoses in Horses

Abstract: 1HS and 2HS jejunoileal anastomosis are equal in strength; however, 1HS results in less relative luminal diameter reduction. SS and FEE have comparable strength but fail at significantly lower BPs than hand-sewn jejunoileal anastomoses.

Cited by 10 publications

References 32 publications

Post‐operative reflux – a surgeon's perspective

Post‐operative reflux – a surgeon's perspective

Current Strategies for Prevention and Treatment of Equine Postoperative Ileus: A Multimodal Approach

Jejunum and Ileum

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