Modified stapled jejunocecostomy in horses.
Authors: Freeman David E, Smith Bryana, Bauck Anje G, Denagamage Thomas, Moyer Elizabeth K, Chanutin Sierra
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Modified Stapled Jejunocecostomy in Horses Freeman and colleagues developed and evaluated a modified stapling technique for jejunocecostomy (JC) in six healthy horses, comparing outcomes against historical data from seven horses that had undergone conventional side-to-side stapled anastomosis. The modified approach eliminates manual oversewing of staple line ends, requiring only a single stapler application and substantially reducing operative time and material costs whilst maintaining anastomotic integrity. All horses recovered without serious complications; at 7-day necropsy, modified stapled anastomoses demonstrated excellent gross healing characteristics with formation of a wide triangulated stoma—a geometric configuration theoretically superior for intestinal flow dynamics and impaction prevention compared to traditional side-to-side construction. Anastomotic dimensions and time to completion were statistically equivalent between the modified and historical control groups at necropsy intervals (p = .49 and p = .32 respectively), suggesting the simplified technique sacrifices nothing in functional outcome. For practitioners managing horses requiring JC surgery—whether for primary resection-anastomosis or as part of more complex colic procedures—this modification offers genuine technical and economic advantages whilst delivering the haemodynamic benefits of a larger, more patent stoma; the triangulated geometry may prove particularly valuable in cases where post-operative impaction represents a clinical concern.
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Practical Takeaways
- •Modified stapled jejunocecostomy is a viable and simpler alternative to side-to-side stapling for horses requiring this procedure, with comparable healing and function
- •The triangulated stoma created by the modified technique may reduce impaction risk, though long-term outcome data at 28 days is limited to historical controls
- •Simplified technique and single stapler application reduce operative time and consumable costs compared to traditional stapled approaches
Key Findings
- •All 6 modified stapled jejunocecostomy horses recovered well with only minor postoperative complications (1 transient mild colic, 1 brief pyrexia/diarrhea)
- •Modified stapled anastomosis time (p=0.49) and lumen size at necropsy (p=0.32) were similar to historical control of 7 side-to-side stapled horses at 28 days
- •Modified stapled technique created a wide triangulated stoma compared to side-to-side method, potentially reducing impaction risk
- •Modified stapled method simplified technique by eliminating oversewn ends and requiring only single stapler application, reducing cost