Comparison of end-to-side versus side-to-side jejunocecostomy in horses.
Authors: Moyer Elizabeth K, Bauck Anje G, Denagamage Thomas, Freeman David E
Journal: Veterinary surgery : VS
Summary
# Jejunocecostomy Techniques in Equine Surgery: A Direct Comparison When intestinal resection is necessary in horses, surgeons must choose between end-to-side (ES) and side-to-side (SS) approaches to create a new connection between the jejunum and caecum—a procedure called jejunocecostomy. Researchers at an equine surgical centre compared these two techniques in 14 healthy horses, measuring operative time, anastomotic dimensions, and clinical outcomes over 28 days post-operatively. The stapled SS technique proved significantly faster (44 minutes versus 54 minutes), whilst creating a substantially larger internal lumen (9.27 cm versus 6.31 cm), though one ES case resulted in ischaemic failure requiring euthanasia compared to no failures in the SS group. Despite these technical differences, postoperative pain scores and heart rates were comparable between groups, with only minor colic in three horses across both techniques, indicating both methods are functionally viable in clinical practice. For practitioners, the SS approach offers advantages in surgical time and anastomotic capacity, though the ES technique remains an option where stapling equipment is unavailable—though additional procedures may be needed to optimise lumen diameter with the hand-sewn method.
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Practical Takeaways
- •Side-to-side stapled jejunocecostomy offers faster surgical completion and larger anastomotic lumen, potentially reducing surgical time and improving long-term patency in colic cases
- •End-to-side technique requires additional procedures to maximize lumen size and carries higher risk of ischemic complications in this protocol, though both remain clinically acceptable
- •Neither technique showed superior postoperative pain control or recovery, so surgical choice can be based on surgeon experience and available equipment
Key Findings
- •Side-to-side jejunocecostomy was completed significantly faster (44.2 min vs 54.2 min, p<0.002) than end-to-side technique
- •Side-to-side anastomosis created a significantly larger internal lumen (9.27 cm vs 6.31 cm, p<0.001) at necropsy
- •One horse in the end-to-side group developed ischemic anastomosis requiring euthanasia; 3 total horses showed mild postoperative colic with no differences between groups
- •Both techniques were functionally well-tolerated with similar postoperative heart rates and pain scores (p>0.16)