Evaluation of the Effect of Onlay Mesenteric Flaps on End‐To‐End Jejunojejunostomy Healing in Horses

Abstract

End-to-end jejunojejunostomy covered with 2 onlay MFs is not recommended because this technique results in luminal reduction.

Clinical evaluation of a jejunojejunal end‐to‐end anastomosis with skin staples with or without coverage by a mesenteric flap

“…The application of the flaps in our cases was consistently different from that used by Aristizabal et al . () which described a transverse incision in the mesentery to increase the length of the flap. Although they do not provide any description of how and if this incision was sutured during surgery, this procedure may cause more inflammation and consequently more contraction of the mesentery.…”

“…Using a continuous pattern instead of simple sutures or drops of cyanoacrylate may limit the effects of the contraction of the mesentery on the intestine allowing the tissue to distribute along the entire length of the suture although there is no proof of this in our cases. Nevertheless, neither in our clinical cases nor those experimental cases reported by Aristizabal et al () did apposition of a mesenteric flap cause signs of colic in the post operative period. The novel technique described in this report was a safe and effective method of performing end‐to‐end jejunojejunal anastomosis for the treatment of strangulating lesions in the horse.…”

“…In a recent study, the effectiveness of this procedure has been questioned (Aristizabal et al . ). In particular, the authors found that the mesenteric flap did not significantly decrease the incidence of adhesions, necessitated longer surgical times and caused stenosis of the intestinal segment around the anastomosis.…”

“…Whilst we cannot be certain that applying a mesenteric flap was truly effective in preventing adhesions, no cases of post operative colic were reported. In a recent study, the effectiveness of this procedure has been questioned (Aristizabal et al 2014). In particular, the authors found that the mesenteric flap did not significantly decrease the incidence of adhesions, necessitated longer surgical times and caused stenosis of the intestinal segment around the anastomosis.…”

Skin staples for end‐to‐end anastomosis with mesenteric onlay flap in horses

“…Gandini and Giusto () state that the flap they used might not be prone to these risks because it differed in construction, specifically use of a simple continuous suture to secure a longer flap to the seromuscular layer of the intestine instead of the interrupted pattern and cyanoacrylate glue used by Aristizabal et al . (). Gandini and Giusto () also reported a shorter total surgery time, which could reduce the risk of adhesions.…”