Handsewn Semiclosed Single-layer Jejunocecal Side-to-side Anastomosis in the Horse

Objective: To report a technique for semiclosed 1-layer side-to-side jejunocecal anastomosis in horses.

Study Design: Experimental study and clinical reports.

Sample Population: Part 1--In vitro: Intestinal specimens from 24 horses collected immediately after death at an abattoir. Part 2--CLINICAL CASES: 10 horses with clinical signs of colic requiring jejunocecostomy.

Methods: Mean time to perform twelve 2-layer handsewn (HS2L) and 12 semiclosed 1-layer modified handsewn (SC) jejunocecal anastomoses was compared. Mean bursting pressures of anastomoses measured with a modified tank inflation test were compared. The SC technique was used in 10 horses that required jejunocecal anastomosis with and without resection (complete or incomplete ileocecal bypass).

Results: The SC technique was significantly quicker to perform than HS2L technique. Clinically, the technique appeared safe with a major complication, associated with obstruction from kinking of the anastomosis, occurring in 1 horse.

Conclusions: The SC technique was easy to perform with very little mucosal exposure in comparison to the HS2L technique, and was safe and effective in restoring intestinal continuity in clinical cases.

Clinical Relevance: The SC technique should be considered for jejunocecostomy in horses because it reduces anastomosis time and mucosal exposure compared with other techniques.