Handsewn semiclosed single-layer jejunocecal side-to-side anastomosis in the horse.
Authors: Gandini Marco
Journal: Veterinary surgery : VS
Summary
# Jejunocecal Anastomosis in Equine Colic Surgery When jejunal or caecal resection becomes necessary in colic cases, surgeons must choose between established anastomotic techniques—a decision that carries implications for operative time, tissue handling, and post-operative outcomes. Gandini's 2010 study evaluated a modified semiclosed, single-layer handsewn technique against the conventional two-layer approach, using in vitro bursting pressure tests on 24 equine cadaveric specimens and clinical application in 10 horses undergoing jejunocecostomy with or without resection. The semiclosed technique significantly reduced operative time compared to two-layer anastomosis whilst maintaining comparable bursting pressures and intestinal integrity, with minimal mucosal exposure during construction. Across the clinical cases, only one horse experienced a major complication (anastomotic kinking causing obstruction), suggesting the technique is both safe and reliable for restoring intestinal continuity. Given that reduced operative time and decreased mucosal trauma may lower infection risk and improve healing, this approach merits consideration as an alternative to traditional two-layer methods in equine jejunocecal anastomosis.
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Practical Takeaways
- •Consider semiclosed single-layer jejunocecostomy technique in colic cases requiring intestinal anastomosis as it reduces operative time and potential mucosal contamination
- •Technique is straightforward to perform but monitor closely for anastomotic kinking post-operatively as this was the primary complication observed
- •This method effectively restores intestinal continuity whether complete or incomplete ileocecal bypass is performed
Key Findings
- •Semiclosed single-layer technique was significantly faster to perform than two-layer handsewn technique
- •Semiclosed technique produced minimal mucosal exposure compared to traditional two-layer approach
- •Clinical safety demonstrated in 10 horses with one major complication (anastomosis kinking causing obstruction) in one horse
- •Bursting pressure measurements showed adequate anastomotic integrity with the modified technique