Anastomose término-terminal no jejuno de eqüinos coberta com retalhos mesentéricos pediculados / Endtoend anastomosis in the equine jejunum covered by pedunculated mesenteric flaps

AUTOR(ES)

Fabio Augusto Aristizábal Mena

DATA DE PUBLICAÇÃO

2006

RESUMO

Resection and anastomosis of the small intestine is commonly performed in horses to treat lesions produced by strangulated obstructions and other diseases. However this procedure is associated with several complications such as peritoneal adhesions, intestinal stenosis at the site of the anastomosis, necrosis of the preserved intestinal stumps, leakage of intestinal contents and septic peritonitis. The present study was conducted to evaluate a single- layer appositional end-to-end anastomosis technique covered by mesenteric flaps with respect to adhesion formation, distortion and stomal diameter. To evaluate the use of n-butyl cyanoacrylate surgical glue to fix a mesenteric flap over the jejunum serosa and to perform skin closure in horses that underwent laparotomy and end-to-end anastomosis in the jejunum. Six healthy horses, without evidence of previous abdominal surgery were used. Midline laparotomy was performed and the jejunum was exteriorized. Two jejunal segments (one aboral and other oral and each corresponding to 2 mesenteric arches) were delimited, 2 and 4 meters proximal to the ileocecal junction, respectively. In a crossover design, each one of the jejunal segments underwent one of the following treatments: resection and end-to-end anastomosis performed with a simple continuous pattern (simple anastomosis) or the same type of anastomosis covered by two mesenteric flaps (conserved from the removed segment) and fixed with n-butyl cyanoacrylate to the anastomosis site. Tissue adhesive was also used to perform skin closure. The animals were euthanized 14 days after surgery and peritoneal adhesions were assigned grades of 0 to 3 according to BAXTER, et al. (1993). A 40 cm segment of jejunum containing the anastomotic site was harvested and distended by barium sulfate solution 0,1% to 20 mmHg and radiographed. Stomal diameter reduction and stenosis length were determined by measuring the barium column visible on the radiographs. Was concluded that the single layer appositional end-to-end anastomosis technique covered by mesenteric flaps was not advantageous and must not be used in equines. Prospective studies are needed to evaluate the use of n-butyl cyanoacrylate in the intestine. The skin suture was simpler and faster when performed with n-butyl cyanoacrylate glue.

ASSUNTO(S)

equino equine intestinal surgery cirurgia intestinal clinica e cirurgia animal adhesions colic aderências cólicas

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