Enterotomy technique in the descending colon of the horse. Effect of location and suture pattern

To compare the effects of placing enterotomy incisions on or off the antimesenteric teniae and closing the intestinal mucosa as a separate layer, four longitudinal enterotomies were performed in the descending colon of each of six horses by the following techniques: incision through the antimesenteric teniae with one- and two-layer closure, and incision adjacent to the teniae with one- and two-layer closure. The horses were necropsied at day 33 for evidence of obstruction, adhesions, and ultrasonographic determination of the percent reduction in lumen diameter. Histologic and histomorphometric evaluations included: inflammatory response in the mucosal and seromuscular layers, mucosal atrophy or degeneration, alignment of the incision edges, area of fibrosis, and distance between the incised muscle edges. Adhesions were present in 5 of 24 enterotomies. Incisions adjacent to the teniae resulted in narrower lumen diameters than incisions through the teniae. Inflammatory response was greatest in incisions adjacent to the teniae with two-layer closure. Closure of the mucosa as a separate layer had no effect on any of the parameters evaluated. Enterotomies through the antimesenteric teniae were more easily performed, resulted in less hemorrhage, and maintained a larger lumen diameter than those performed adjacent to the teniae.