Clinical comparison between a continuous Lembert pattern wrapped in a carboxymethylcellulose and hyaluronate membrane with an interrupted Lembert pattern for one-layer jejunojejunostomy in horses

• Published in: Equine veterinary journal 2011-11, Vol.43 (6), p.708-713
• Main Authors: Freeman, D.E, Schaeffer, D.J
• Format: Article
• Language: English
• Subjects: Aging; Animals; carboxymethylcellulose; Carboxymethylcellulose Sodium; colic; death; endotoxemia; Gastrointestinal Diseases - surgery; Gastrointestinal Diseases - veterinary; horse; Horse Diseases - surgery; Horses; Hyaluronic Acid; intestinal obstruction; jejunojejunostomy; Jejunostomy - methods; Jejunostomy - veterinary; mortality; post operative ileus; probability; Retrospective Studies; survival; Suture Techniques - veterinary
• ISSN: 0425-1644; 2042-3306
• DOI: 10.1111/j.2042-3306.2010.00340.x

Reasons for performing study: Although experimental studies have demonstrated differences in performance between methods for handsewn jejunojejunostomy in horses, information on clinical results after different methods of anastomosis are rare. Hypothesis: A continuous Lembert pattern wrapped in a carboxymethylcellulose and hyaluronate membrane would perform better than an interrupted Lembert pattern for jejunojejunostomy in horses. Methods: Data was reviewed on 32 horses that underwent jejunojejunostomy from 1993–2002. Kaplan-Meier analyses and rates for post operative colic and death were used to compare outcomes after an interrupted Lembert pattern (15 horses with strangulating lesions and 5 horses with nonstrangulating lesions) and a continuous Lembert pattern with membrane (12 horses with strangulating diseases). Results: None of the 32 horses had post operative ileus or post operative endotoxaemia. One horse with a continuous pattern required a repeat celiotomy for anastomotic impaction. Short-term survivals for the interrupted Lembert were 100% (nonstrangulating lesions) and 93% (strangulating lesions) and for the continuous pattern 92% (all strangulating). Long-term rates for mortality and colic episodes were less for the continuous Lembert pattern with membrane compared with the interrupted Lembert for strangulating lesions (P