Comparison of one-layer (continuous Lembert) versus two-layer (simple continuous/Cushing) hand-sewn end-to-end anastomosis in equine jejunum

Jorge Nieto, Julie E Dechant, Jack R. Snyder

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objective - To evaluate single and double layer end-to-end anastomosis in equine jejunum. Study Design - Experimental in vitro study. Animals - Mid-jejunal sections from 12 adult horses without gastrointestinal disease. Methods - Jejunal end-to-end anastomoses were performed by a continuous Lembert pattern or a simple continuous pattern oversewn with a Cushing pattern. Jejunal segments were distended with fluid at 1 L/min, and intraluminal pressure at failure, and mode of failure were recorded. Bursting pressure and bursting wall tension were calculated. Anastomosis construction time and degree of luminal reduction were recorded. Results - Single layer anastomoses were constructed in less time than 2-layer anastomoses. Both anastomotic techniques resulted in luminal reduction compared with control tissue; however, the reduction was smaller with a 1-layer continuous Lembert anastomosis. No differences were noted in bursting pressure or bursting wall tension between groups. Conclusions - Anastomosis using a 1-layer continuous Lembert pattern resulted in a larger stoma, was faster to perform, and as strong as a 2-layer anastomosis. Clinical Relevance - 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.

Original languageEnglish (US)
Pages (from-to)669-673
Number of pages5
JournalVeterinary Surgery
Volume35
Issue number7
DOIs
StatePublished - Oct 2006

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Jejunum
jejunum
Horses
hands
Hand
horses
Pressure
stomata
Gastrointestinal Diseases
digestive system diseases
in vitro studies
Research Design
experimental design
methodology
animals

ASJC Scopus subject areas

  • veterinary(all)

Cite this

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title = "Comparison of one-layer (continuous Lembert) versus two-layer (simple continuous/Cushing) hand-sewn end-to-end anastomosis in equine jejunum",
abstract = "Objective - To evaluate single and double layer end-to-end anastomosis in equine jejunum. Study Design - Experimental in vitro study. Animals - Mid-jejunal sections from 12 adult horses without gastrointestinal disease. Methods - Jejunal end-to-end anastomoses were performed by a continuous Lembert pattern or a simple continuous pattern oversewn with a Cushing pattern. Jejunal segments were distended with fluid at 1 L/min, and intraluminal pressure at failure, and mode of failure were recorded. Bursting pressure and bursting wall tension were calculated. Anastomosis construction time and degree of luminal reduction were recorded. Results - Single layer anastomoses were constructed in less time than 2-layer anastomoses. Both anastomotic techniques resulted in luminal reduction compared with control tissue; however, the reduction was smaller with a 1-layer continuous Lembert anastomosis. No differences were noted in bursting pressure or bursting wall tension between groups. Conclusions - Anastomosis using a 1-layer continuous Lembert pattern resulted in a larger stoma, was faster to perform, and as strong as a 2-layer anastomosis. Clinical Relevance - 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.",
author = "Jorge Nieto and Dechant, {Julie E} and Snyder, {Jack R.}",
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AU - Dechant, Julie E

AU - Snyder, Jack R.

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AB - Objective - To evaluate single and double layer end-to-end anastomosis in equine jejunum. Study Design - Experimental in vitro study. Animals - Mid-jejunal sections from 12 adult horses without gastrointestinal disease. Methods - Jejunal end-to-end anastomoses were performed by a continuous Lembert pattern or a simple continuous pattern oversewn with a Cushing pattern. Jejunal segments were distended with fluid at 1 L/min, and intraluminal pressure at failure, and mode of failure were recorded. Bursting pressure and bursting wall tension were calculated. Anastomosis construction time and degree of luminal reduction were recorded. Results - Single layer anastomoses were constructed in less time than 2-layer anastomoses. Both anastomotic techniques resulted in luminal reduction compared with control tissue; however, the reduction was smaller with a 1-layer continuous Lembert anastomosis. No differences were noted in bursting pressure or bursting wall tension between groups. Conclusions - Anastomosis using a 1-layer continuous Lembert pattern resulted in a larger stoma, was faster to perform, and as strong as a 2-layer anastomosis. Clinical Relevance - 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.

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