Closed one-stage functional end-to-end jejunojejunostomy in horses with use of linear stapling equipment.

Abstract

To use gastrointestinal linear stapling instrumentation to perform a closed one-stage functional end-to-end jejunojejunostomy in adult horses as an alternative to a stapled side-to-side jejunojejunostomy. Clinical outcome, anatomic and histological architecture, and anastomotic dimensions were determined at 2, 4, 8, 16, and 24 weeks postoperatively. 18 adult horses. The anastomosis and peritoneal cavity were inspected for adhesions. The diameter and circumference of the anastomosis and jejunum oral and aboral to the anastomosis were determined from digitized contrast radiographs and linear measurements. Healing of anastomotic sites was evaluated histologically. Three horses were euthantized in the immediate postoperative period. In the 15 surviving horses, there were no peritoneal adhesions or distortion of the anastomoses and stomas remodeled in an end-to-end fashion. The mean anastomotic staple line (7.48 cm) and mucosa (6.89 cm) diameters were significantly (P < .05) larger than the mean jejunal diameter oral (6.03 cm) and aboral (6.01 cm) to the anastomosis. The mean anastomotic luminal circumference (13.61 cm) was significantly (P < .01) larger than the mean oral (11.43 cm) and aboral (11.12 cm) jejunal circumference. Histologically, there was adequate mucosal and muscularis mucosae reapposition with a moderate degree of fibrosis and inflammation. Closed one-stage functional end-to-end jejunojejunostomy resulted in an acceptable functional anastomosis. This technique appears to be an acceptable alternative to linearly stapled, side-to-side jejunojejunostomies performed in horses.