Intestinal Anastomoses In Dogs Research Articles

The effect of therankeron D6 on the healing of intestinal anastomosis in dogs

To investigate the effects of systemic administration of Theranekron (Tarantula cubensis) extract as homeopathic remedy on anastomosis healing after surgical intestinal resection. Eight healthy stray dogs (age 1-1.5 years, weight 15-20 kgs) were randomly divided into two groups; control (4 animals) and treatment group (4 animals). Intestinal resection and anastomosis were performed in all animals in both groups. Theranekron D6 (3 ml) was administered subcutaneously one week before surgery and at operation time in the treatment group whereas animals of the control group were injected 3 ml of normal saline at the same time points of treatment group. All animals were kept for 15 days following surgery and a segment of intestine was removed for histopathological and press pressure measurement. The results showed that no post-operative complications have been observed in both groups. The gross examination of the anastomosis site revealed sever adhesions with omentum and other intestinal segment of the all animals of the control group in comparison to the treatment group where lesser adhesions with omentum without any adhesion with the other intestinal segment have been noticed. There was slight difference between control and treatment group in relation to histopathological examination. In conclusion, the findings of this study showed that Theranekron was able to improve the healing process of the resected and anastomosed intestinal segment

Gastrointestinal thickness, duration, and leak pressure of six intestinal anastomoses in dogs.

To compare leak pressures and construct completion time of six intestinal anastomoses and report normal canine gastrointestinal thickness. Experimental study. Grossly normal jejunal segments (n = 140) from 10 fresh canine cadavers. Gastrointestinal thickness was recorded. Eight-centimeter cooled canine cadaveric jejunal segments were randomly assigned to a control group (20 segments) and six treatment groups (20 segments/group [10 constructs/group]): (1) handsewn anastomosis (HSA), (2) functional end-to-end stapled anastomosis (FEESA)-blue thoracoabdominal (TA; FEESA-TAB), (3) FEESA-green TA (FEESA-TAG), (4) FEESA TA-gastrointestinal anastomosis (GIA), (5) FEESA with suture oversew (FEESA-O), and (6) skin staples (SS). Construct assembly time, initial leak pressure (ILP), maximum intraluminal pressure (MIP), and leakage location were compared. Initial leak pressures (mean ± SD) for control (308.38 ± 115.91 mm Hg), HSA (41.96 ± 15.97), FEESA-TAB (31.71 ± 15.71), FEESA-TAG (27.24 ± 14.11), FEESA-GIA (25.62 ± 11.22), FEESA-O (31.01 ± 17.38), and SS (44.42 ± 28.88) groups were compared. No difference in ILP (P > .24) or MIP (P > .17) was detected between treatment groups. Sutured anastomoses took up to 10 times longer to complete (P = .0025). The stomach, duodenum, jejunum, and ileum mural thicknesses (mean ± SD) were 3.99 ± 0.44 mm, 2.34 ± 0.16, 2.49 ± 0.28, and 2.30 ± 0.31, respectively. The ILP of all anastomoses exceeded maximum intraluminal peristaltic pressures. Stapled anastomoses were faster to complete. All anastomoses may be considered when performing an intestinal resection and anastomosis, with stapled anastomoses resulting in a shorter surgical time. Canine intestinal thickness may warrant use of a larger staple size.

Influence of oversewing the transverse staple line during functional end-to-end stapled intestinal anastomoses in dogs.

To determine the effect of oversewing the transverse staple line after functional end-to-end stapled intestinal anastomoses (FEESA) on canine jejunal leakage pressures. Experimental, ex vivo, randomized study. Jejunal segments from three adult canine cadavers. Jejunal segments were harvested within 2 hours of euthanasia and anastomosed (24 jejunal segments per group, consisting of two segments per construct with n = 12/ group). Constructs were then randomly assigned to receive FEESA alone, FEESA + Cushing oversew, or FEESA + simple-continuous oversew of the transverse staple line with 3-0 polydioxanone. Results for initial leakage pressure (ILP) and maximal leakage pressure (MLP) and initial leakage location (LL) were compared between groups. Mean ILP was 1.8-fold higher for FEESA + Cushing oversew (62.4 ± 7.8 mm Hg) compared with FEESA alone and FEESA + simple-continuous oversew (P < .001). Mean MLP were higher for both oversewn techniques compared with FEESA alone (P < .001). Oversewing the transverse staple line with either pattern increased mean MLP by 1.4-fold compared with FEESA alone. Leakage occurred at the level of the transverse staple line in nonoversewn constructs (P < .001). Oversewing the transverse staple line after FEESA increased MLP and decreased the occurrence of leakage at this location. Oversewing with a Cushing pattern increased ILP compared with oversew with a simple-continuous pattern. Our results provide evidence to support oversewing the transverse staple line after FEESA. Doing so may reduce the occurrence of postoperative dehiscence. These findings warrant additional focused investigation in vivo through a prospective randomized clinical trial.

Frequency of Dehiscence in Hand-Sutured and Stapled Intestinal Anastomoses in Dogs.

To determine the frequency of dehiscence of hand-sutured and stapled intestinal anastomoses in the dog and compare the surgery duration for the methods of anastomosis. Historical cohort study. Two hundred fourteen client-owned dogs undergoing hand-sutured (n = 142) or stapled (n = 72) intestinal anastomoses. Medical records from 5 referral institutions were searched for dogs undergoing intestinal resection and anastomosis between March 2006 and February 2014. Demographic data, presence of septic peritonitis before surgery, surgical technique (hand-sutured or stapled), surgery duration, surgeon (resident versus faculty member), indication for surgical intervention, anatomic location of resection and anastomosis, and if dehiscence was noted postoperatively were retrieved. Estimated frequencies were summarized and presented as proportions and 95% confidence intervals (CI) and continuous outcomes as mean (95% CI). Comparisons were made across methods of anastomosis. Overall, 29/205 dogs (0.14, 95% CI 0.10-00.19) had dehiscence, including 21/134 dogs (0.16, 0.11-0.23) undergoing hand-sutured anastomosis and 8/71 dogs (0.11, 0.06-0.21) undergoing stapled anastomosis. There was no significant difference in the frequency of dehiscence across anastomosis methods (χ(2), P = .389). The mean (95% CI) surgery duration of 140 minutes (132-147) for hand- sutured anastomoses and 108 minutes (99-119) for stapled anastomoses was significantly different (t-test, P < .001). No significant difference in frequency of dehiscence was noted between hand- sutured and stapled anastomoses in dogs but surgery duration is significantly reduced by the use of staples for intestinal closure.

Risk Factors for Dehiscence of Stapled Functional End-to-End Intestinal Anastomoses in Dogs: 53 Cases (2001-2012).

To identify risk factors for dehiscence in stapled functional end-to-end anastomoses (SFEEA) in dogs. Retrospective case series. Dogs (n = 53) requiring an enterectomy. Medical records from a single institution for all dogs undergoing an enterectomy (2001-2012) were reviewed. Surgeries were included when gastrointestinal (GIA) and thoracoabdominal (TA) stapling equipment was used to create a functional end-to-end anastomosis between segments of small intestine or small and large intestine in dogs. Information regarding preoperative, surgical, and postoperative factors was recorded. Anastomotic dehiscence was noted in 6 of 53 cases (11%), with a mortality rate of 83%. The only preoperative factor significantly associated with dehiscence was the presence of inflammatory bowel disease (IBD). Surgical factors significantly associated with dehiscence included the presence, duration, and number of intraoperative hypotensive periods, and location of anastomosis, with greater odds of dehiscence in anastomoses involving the large intestine. IBD, location of anastomosis, and intraoperative hypotension are risk factors for intestinal anastomotic dehiscence after SFEEA in dogs. Previously suggested risk factors (low serum albumin concentration, preoperative septic peritonitis, and intestinal foreign body) were not confirmed in this study.

Estudo comparativo entre os fios de algodão, poliglactina e poliglecaprone nas anastomoses intestinais de cães

Over the years, many sutures were developed and then abandoned. Until now was not found an ideal suture to the intestinal tract or other tissues in general, making the choice a difficult task. To evaluate, macroscopically and microscopically, the healing process of intestinal anastomoses in dogs using polyglecaprone 25, polyglactin 910 and cotton sutures. Twenty adult male dogs were operated on and underwent to three small bowel anastomosis using the technique with submucosal sutures. Were used three threads and the anastomoses were evaluated at different postoperative periods - group I - three days; group II - seven days; group III - 14 days and group IV - 21days. Macroscopic analysis was to assess the presence or absence of peritonitis, aspect of the anastomosis and adhesions. Histological studies of the anastomoses, using hematoxylin and eosin and Masson's trichrome analyzed the exudative inflammation, granulomatous inflammation, the mucosal epithelial coating and collagen fibers. The macroscopic analysis showed good coaptation of the edges with a moderate degree of adhesion between the intestines and omentum three to 21 days after surgery. The microscopic evaluation revealed exudative inflammation with neutrophils and fibrin, which ranged from mild to moderate until the 14th day; granulomatous inflammation with macrophages, multinucleated giant cells and epithelioid cells were more evident at 14th day for the cotton, presence of granulation tissue (fibroblasts) and collagen fibers, a moderate way, from the 7th for the three threads. All three threads showed similar behavior and thus they can be indicated for anastomoses of the small intestine.

Comparison of laparoscopic and conventional surgery of intestinal anastomosis in dogs

The aim of this study was to evaluate operative laparoscopy in comparison with conventional laparotomy for intestinal resection and anastomosis in dogs. Eighteen adult dogs were equally and randomly divided into 3 groups: Group I: Intestinal anastomosis was performed extracorporeally, by laparoscopic-assisted surgery, in which a 5cm loop of small bowel was exteriorized through a mini-laparotomy opening (an enlarged trocar incision 1.5-2 cm in length), then surgically resected and anastomosed by simple interrupted suture 3-0 polygalactine. Group II: Underwent laparoscopic intracorporeal intestinal resection and anastomosis, in which the loop of the small bowel was suspended into the ventral abdominal wall, then it was resected and anastomsed with simple continuous suture by polygalactine 3-0. Group III: Small bowel resection and anastomosis was conducted by conventional laparotomy technique with simple interrupted pattern by polygalactine 3-0 suture. The result showed that laparoscopic intestinal resection and anastomosis by either intra- or extracorporeal techniques can be applied in dogs safely and have less morbidity rate. Intra abdominal adhesion of the omentum and even the bowel to the abdominal wall occurred in group III but not in groups I and II. The post operative hospitalization time was earlier in group I and II, as indicated by the earlier return of intestinal motility and appetite, in comparison to group III where it was delayed.

Comparative study between two methods of end-to-end oblique intestinal anastomosis in dogs

The current study was conducted to compare between two methods of small intestinal anastomosis in dogs after obliquely resected and anastomosed by using simple interrupted and cross mattress sutures technique. The results revealed that the oblique technique of intestinal anastomosis was successful in all operative animals with few complications and without mortality rate postoperatively. The postmortem examination revealed that the cross mattress technique was associated with minimal adhesion as compare to simple interrupted technique which was associated with sever adhesion .The radiographic study revealed that no significant differences in mean degree of stenosis between two methods of this study. Also the radiographic pictures revealed that, the mean degree of stenosis which associated with cross mattress pattern was less than accompanied with simple interrupted pattern at thirty days after operation. The histopathological examination shown minute foci of tissue reaction with thick and mature fibrous tissue at the site of operation after 30 days in cross mattress anastomosis, whereas the anastomosis with the simple interrupted suture accompanied by sever inflammation and destruction of the serosal layer of intestine at 30 days after operation .We concluded that simple interrupted and cross mattress patterns can be used for anastomosis of oblique intestinal resection.

Risk factors for leakage following intestinal anastomosis in dogs and cats: 115 cases (1991-2000).

To identify factors associated with leakage following intestinal anastomosis in dogs and cats. Retrospective study. 90 dogs and 25 cats. Medical records of all dogs and cats that underwent intestinal resection and anastomosis between 1991 and 2000 were reviewed, and information on 27 factors was recorded. Anastomotic leakage was identified in 13 of the 90 dogs but in none of the 25 cats. Preoperative factors significantly associated with development of anastomotic leakage in dogs included preoperative peritonitis, serum albumin concentration, a left shift, and indication for surgery (dogs with intestinal foreign bodies were more likely to have leakage than dogs that underwent surgery for any other cause). Postoperative and case management factors significantly associated with development of leakage included duration of hospitalization, supplemental alimentation, whether the dog ate the day after surgery, blood product administration, and outcome (died vs survived). Discriminant analysis was performed, and dogs with 2 or more of the following factors were predicted to develop anastomotic leakage: preoperative peritonitis, intestinal foreign body, and serum albumin concentration < or = 2.5 g/dL. The model accurately predicted whether leakage would develop in 67 of 80 (84%) dogs. Results suggest that a variety of factors may be associated with development of intestinal anastomotic leakage in dogs. In particular, dogs with 2 or more of the following risk factors are predicted to be at high risk for developing anastomotic leakage: preoperative peritonitis, intestinal foreign body, and serum albumin concentration < or = 2.5 g/dL.

Surgery of the Esophagus

There are many anastomotic techniques available that have been used successfully but no one technique guarantees 100 per cent success. Therefore the surgeon should be capable of altering his planned approach according to the circumstances. No matter what anastomotic technique is selected, for a consistently successful outcome it is imperative that the whole animal be considered in all aspects of care and rude handling of tissues be avoided during the surgical procedure. The simple interrupted approximating suture technique is recommend as one which meets the general goals of intestinal anastomosis in dogs and cats.

Effect of ACTH on strength of intestinal anastomoses in dogs.

SummarySuture line leakage was not observed in a series of 10 dogs given large daily doses of ACTH following end to end anastomosis of the colon. The strength of the suture lines was not significantly altered by ACTH administration as compared with non-treated controls. No correlation was evident between the amount of ACTH given and the strength or gross appearance of the anastomoses.

EFFECT OF OXIDIZED CELLULOSE IN THE PROTECTION OF THE SUTURE LINE IN INTESTINAL ANASTOMOSES IN DOGS

LEAKAGE from the suture line in intestinal anastomoses is a complication of the gravest nature. Since oxidized cellulose, an absorbable substance that can be left in the tissues, has been introduced into surgical practice, its value as a protective aid in intestinal anastomoses seemed worthy of investigation. The literature on intestinal anastomoses has been extremely voluminous.1The fundamental work of Lembert2and Halsted,3insisting on the importance of the serosal and submucosal sutures, remains the basis of successful anastomoses of the bowel. As revealed by a rather extensive search of the literature,1the use of materials in protection of the anastomotic suture line apparently has not been reported to any great extent. Freeman4suggested the use of omental grafts for this purpose; Fenton and Peet5reported on the use of omental grafts in intestinal anastomoses in dogs. Devine6presented a preliminary report in