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Gastrointestinal thickness, duration, and leak pressure of five intestinal anastomosis techniques in cats. | LitMetric

AI Article Synopsis

  • The study aimed to compare the construction time and leakage resistance of five intestinal anastomosis techniques in cats while also measuring normal gastrointestinal thickness.
  • A total of 120 segments of cat intestines were used to test techniques, including hand-sewn and stapled methods, measuring factors like time taken and internal pressure after construction.
  • Results showed that while all methods prevented leakage beyond normal pressure levels, stapled techniques were significantly faster to perform compared to hand-sewn methods.

Article Abstract

Objective: To compare time to construct completion and resistance to leakage for five intestinal anastomosis techniques in cats and to report normal feline gastrointestinal thickness.

Study Design: Experimental study.

Sample Population: Grossly normal intestinal segments (n = 120) from 10 fresh cat cadavers.

Methods: A total of 8 cm segments of fresh feline cadaveric intestine were collected, and mural thickness was recorded. Segments were randomly allocated between a control group (n = 20 segments) and five treatment groups (20 segments/group with 2 segments/construct = 10 constructs per group): (1) hand-sewn anastomosis - simple interrupted (HSA-SI), (2) hand-sewn anastomosis - simple continuous (HSA-SC), (3) functional end-to-end stapled anastomosis (FEESA), (4) functional end-to-end stapled anastomosis with oversew (FEESA-O), (5) skin stapled anastomosis (SS). Time to construct completion, leakage location, initial leak pressure (ILP), and maximum intraluminal pressure (MIP) were compared.

Results: Mean mural thickness ± SD (mm) for the stomach, duodenum, jejunum, and ileum were 1.66 ± 0.28, 2.05 ± 0.18, 2.28 ± 0.30, and 2.11 ± 0.39, respectively. ILPs (mean ± SD) for HSA-SI (165 ± 122 mmHg), HSA-SC (149 ± 83), FEESA-O (63 ± 25, FEESA (84 ± 59), SS (77 ± 56), and control segments (>500) were compared. There was no statistically significant difference in ILP (p > .08) or MIP (p > .084) between any treatment groups. Nonoversewn FEESAs were 2.4 times faster to perform compared to oversewn FEESA and SS groups, and 4.7 times faster than HSA (p < .001).

Conclusion: All anastomosis techniques provide resistance to leakage that is supraphysiological to that of the normal maximum intraluminal pressure. HSA take longer to complete than stapled anastomoses.

Clinical Significance: All anastomotic techniques may be appropriate in cats. Hand-sewn anastomoses result in a longer surgical time.

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Source
http://dx.doi.org/10.1111/vsu.14043DOI Listing

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