Comparison of one-layer (continuous Lembert) versus two-layer (simple continuous/Cushing) hand-sewn end-to-end
Jorge E Nieto1, Julie E Dechant, Jack R Snyder
1Department of Surgical and Radiological Sciences Comparative Gastroenterology Laboratory, School of Veterinary Medicine, University of California - Davis, Davis, CA, USA. jenieto@ucdavis.edu
Objective:
To evaluate single and double layer end-to-end anastomosis in equine jejunum.
Study Design:
Experimental in vitro study.
Animals:
Mid-jejunal sections from 12 adult horses without gastrointestinal disease.
Methods:
Jejunal end-to-end anastomoses were performed by a continuous Lembert pattern or a simple continuous pattern oversewn with a Cushing pattern. Jejunal segments were distended with fluid at 1 L/min, and intraluminal pressure at failure, and mode of failure were recorded. Bursting pressure and bursting wall tension were calculated. Anastomosis construction time and degree of luminal reduction were recorded. Results- Single layer anastomoses were constructed in less time than 2-layer anastomoses. Both anastomotic techniques resulted in luminal reduction compared with control tissue; however, the reduction was smaller with a 1-layer continuous Lembert anastomosis. No differences were noted in bursting pressure or bursting wall tension between groups.
Conclusions:
Anastomosis using a 1-layer continuous Lembert pattern resulted in a larger stoma, was faster to perform, and as strong as a 2-layer anastomosis.
Clinical Relevance:
Use of a 1-layer continuous Lembert pattern for jejunojejunosotomy may be beneficial by decreasing anastomosis time and produce a larger stoma than a 2-layer anastomosis.
