Comparison of staple and suture techniques for partial typhlectomy in the cow: a prospective clinical study of 40...

Two techniques for partial typhlectomy were evaluated on 20 cows each suffering from dilatation/torsion of the cecum. In a preliminary study on two cows the suitability of a stainless steel staple pattern using two TA 90 cartridges of 4.8 mm and 3.5 mm staples respectively was examined and the technique standardized. In the main clinical study the stapling pattern (group I) was compared with a simple continuous full thickness appositional suture oversewn with a continuous Cushing suture (group II). The cartridges with the 4.8 mm staples were used in 7 clinical cases, with intestinal wall edema and the 3.5 mm staples were used in 13 cases. Arterial bleeding from the cecal stump occurred in 20 out of 22 cases (including the results of the preliminary study). The number of arteries that had to be ligated was statistically significantly higher (p less than 0.05) with the 4.8 mm staples than with the 3.5 mm staples. The additional ligation of bleeding vessels prolonged the surgical procedure. Seventeen out of 20 cows (85%) of each group were discharged from the clinic. The duration of the hospital stay was 6 days for both groups. Fourteen cows (70%) of each group were still alive upon inquiry. One cow of the stapling group was slaughtered because of a severe fibrinous peritonitis at the resection site. In the other 11 cows there was no evidence of a connection between the surgery and the slaughtering.