Ex vivo comparison of different thoracoabdominal stapler sizes for typhlectomy in canine cadavers.

Abstract

To determine the influence of staple size on leakage pressure of typhlectomy sites in canine cadavers. Randomized, experimental cadaveric study. Twenty-four fresh canine cadavers. Ileocecocolic segments were exteriorized following right paracostal laparotomy after euthanasia. Cecal base length and wall thickness were measured. Each cecum was randomly assigned to 1 of 3 groups (TA 30 V3 2.5 mm, TA 60 3.5 mm, and TA 60 4.8 mm). The cecal base was stapled and the cecum was removed. A 10cm segment including the stapled cecal excision site was tested for initial leak pressure. The mean ± standard deviation body weights across the groups were 18.7 ± 6.1kg, 16.2 ± 7.5kg, and 14.2 ± 5.5kg for the TA 30 V3 2.5 mm, TA 60 3.5 mm, and TA 60 4.8 mm groups, respectively (P=.48). There were no differences for mean cecal base length or wall thickness. Mean initial leak pressure (ILP) across groups was 182 ± 111 mmHg (TA 30 V3 2.5 mm), 112 ± 57 mmHg (TA 60 3.5 mm), and 77 ± 60 mmHg (TA 60 4.8 mm) (P=.78). Each stapler size that was evaluated resulted in a mean ILP in excess of typical intraluminal pressures under normal circumstances. There were no differences among groups. The results of this cadaveric study support the use of any of the stapler sizes evaluated in similarly sized dogs. A prospective study is needed to be able to correlate stapler size and clinical outcome.