Evaluation of the effect of onlay mesenteric flaps on end-to-end jejunojejunostomy healing in horses

Objective: To evaluate the effect of onlay mesenteric flaps (MFs) with end-to-end jejunojejunostomy on stomal diameter, length of jejunum with reduced stomal diameter, abdominal adhesion formation, and healing. Study Design: Experimental study. Animals: Healthy adult horses (n=6). Methods: Two hand sewn end-to-end jejunal anastomoses using a 1 layer simple continuous serosubmucosal suture pattern were performed in each horse ∼2 and 5m oral to the ileocecal fold. Using a random design for selection anastomosis location (oral or aboral), 1 anastomosis was covered with 2 adjacent onlay MFs secured with interrupted sutures and cyanoacrylate glue. Two weeks later, adhesion formation, stomal diameter, length of reduced jejunal stomal diameter, and healing were evaluated. Results: Use of onlay MFs decreased stomal diameter (P= 05), increased length of reduced peristomal jejunal diameter (P= 05), surgical time (P= 003), and serosal fibrosis (P= 05). No difference was evident for adhesion formation, and degree of inflammation between techniques. Conclusion: End-to-end jejunojejunostomy covered with 2 onlay MFs is not recommended because this technique results in luminal reduction.