34th Annual Scientific Meeting proceedings

Objectives:

Small colon enterotomy is a surgical procedure commonly performed to remove impactions caused by fecaliths, enteroliths, or other foreign bodies. Although a two-layer suture technique is frequently employed in such cases, it may reduce lumen size and increase surgery time.

Methods:

Small colons were harvested from five horses within six hours of euthanasia, divided into 40 cm segments, and thoroughly rinsed. Two ECVS Diplomate surgeons performed a 10 cm enterotomy on each randomly assigned segment, which was then closed using one of three techniques: a single-layer continuous Lembert, a single-layer simple interrupted Lembert, or a two-layer simple continuous followed by Cushing, using 2-0 polydioxanone suture. Bursting pressure was assessed using an arthroscopy pump at 1 L/min and a digital manometer (Dwyer DPG-000). Methylene blue solution was introduced until leakage or rupture occurred, and lumen restriction was evaluated by measuring the opened samples with a ruler. 

Results:

A total of twenty-four (24) sutured segments were included in the study, evenly distributed among the three groups. Most intestinal segments (90%) ruptured at the tenia-serosal interface. No significant differences were observed in bursting pressure (mmHg) or lumen size between the groups (p=0.97 and p=0.2). However, the time required for suturing differed significantly, with the single-layer continuous Lembert technique being notably faster than the two-layer suturing method (p=0.03).

Conclusions:

The single-layer continuous Lembert technique significantly reduces surgical time compared to other methods while maintaining safety regarding bursting pressure. This study did not consider the mechanical effects of fecal balls or enteroliths, which may impact outcomes.