Comparison of end-to-side versus side-to-side jejunocecostomy in horses

To compare end-to-side (ES) and side-to-side (SS) jejunocecostomy (JC) in healthy horses.

Experimental study in vivo.

A total of 14 healthy adult horses underwent ventral midline celiotomy, a resection, and either an ES (n = 7) or stapled SS (n = 7) JC.

Surgical times and the external lengths of completed anastomoses were measured. Physical examinations and pain scoring were performed every 6 h for 5 days, then once daily until euthanasia and necropsy 28 days postoperatively.

The anastomosis was completed more rapidly (p < .002) with the SS JC (mean 44.21 ± 4.91 min) than the ES JC (mean 54.24 ± 4.59 min). One horse in the ES group developed colic from an ischemic anastomosis and was euthanized. Three horses (1 ES JC and 2 SS JC) exhibited mild colic postoperatively, and the remaining horses had no complications. Postoperative heart rates and pain scores were similar between groups (p < .16 and p < .67, respectively). The internal length of the anastomosis was significantly larger (p < .001) in the SS JC (mean 9.27 ± 1.05 cm) than the ES JC (mean 6.31 ± 1.4 cm) at necropsy.

Both methods for JC were well tolerated and functional in both groups using the selected protocols for anesthesia, surgery and aftercare.

This study provides evidence that both stapled SS JC and handsewn ES JC are acceptable for use in clinical cases, although additional procedures are required to maximize lumen size with the ES JC.