Initial leak pressures of four anastomosis techniques in cooled cadaveric canine jejunum
Mark J. Fealey, Penny J. Regier, Charles Steadman BS, J. Brad Case, Fernando L. Garcia‐Pereira
Abstract
OBJECTIVE: To compare the effectiveness of four different intestinal anastomosis techniques at preventing leakage after enterectomy. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Grossly normal jejunal segments (N = 70) from three fresh canine cadavers. METHODS: Eight-centimeter cooled canine cadaveric jejunal segments were randomly assigned to a control group (six segments) and four treatment groups (16 segments each [two segments/anastomotic construct]): (1) handsewn anastomosis (HSA), (2) barbed suture anastomosis (B-HSA), (3) stapled functional end-to-end anastomosis (SFEEA), and (4) stapled functional end-to-end anastomosis with an oversew (SFEEA-O). Control segments and anastomotic constructs were infused intraluminally to the point of leakage. Initial leak pressures were recorded and compared. RESULTS: Initial leak pressures (median + range) for jejunal control segments, HSA, B-HSA, SFEEA, and SFEEA-O were 331.88 mmHg (range, 315.34-346.64), 35.17 (20.29-56.24), 24.99 (6.08-38.64), 28.77 (18.80-85.09), and 35.92 (12.05-80.71), respectively. No difference was detected between leak pressures of anastomosed segments (P = .35), all of which were more variable and lower than those of intact segments. CONCLUSION: No difference in initial leak pressures was detected between the four anastomosis techniques tested in cooled canine cadaveric jejunum. CLINICAL SIGNIFICANCE: All four anastomosis techniques evaluated in this study may be suitable in dogs.