Comparison of hand-sewn and oversewn stapled jejunojejunal anastomoses in horses

The objective of this study was to compare the biomechanical properties of hand-sewn jejunojejunal anastomoses to those of oversewn stapled jejunojejunal anastomoses. Jejunojejunal anastomoses were constructed from harvested jejunal segments using a single-layer Lembert technique (1HS), double-layer simple continuous/Cushing technique (2HS), stapled side-to-side technique oversewn with Cushing pattern (SS), and closed 1-stage stapled functional end-to-end technique oversewn with Cushing pattern (FEE). Anastomosed segments were distended with fluid until the point of biomechanical failure. The 2HS had the longest construction time of all anastomoses. Bursting pressures were significantly higher for hand-sewn jejunojejunostomies than those for oversewn stapled jejunojejunostomies. No significant differences were found in bursting pressures between 1HS and 2HS or between SS and FEE. Hand-sewn jejunojejunostomies proved to be biomechanically stronger than oversewn stapled jejunojejunostomies when initially constructed. However, all anastomotic types would be secure techniques to be used clinically based on the supraphysiological pressures they are capable of withstanding.