Ex vivo comparison of one-layer versus two-layer closures in end-to-end anastomoses in normal equine descending colon.

Abstract

Objective: The aim of the study was to evaluate time to closure, bursting pressures and luminal diameters of a single and double-layer end-to-end anastomoses in normal equine descending colon.

Study design: Experimental study.

Sample population: Eight adult horses.

Methods: Four segments of descending colon from each horse were randomly assigned to a control (n = 8, CON), one-layer (n = 12, group 1; continuous Lembert pattern), or two-layer group (n = 12, group 2; simple continuous oversewn with Cushing pattern). Anastomoses were performed, and time to closure and luminal diameter were measured. Bursting pressures were determined, and location of failure was recorded. Mixed analysis of variance (ANOVA) was employed.

Results: Mean time to completion was decreased (p = .003) in group 1 (18.6 min ± 22.8 s) compared with group 2 (21.35 min ± 22.8 s). Luminal diameter was reduced (p < .0001) in group 2 (47 ± 2.46 mm) compared to group 1 (65 ± 2.77 mm). Location of failure was remote to the anastomosis in all but one segment; therefore, differences in anastomotic bursting pressures could not be determined.

Conclusion: Two-layer closures resulted in significant luminal reduction and took longer to complete than one-layer anastomoses.

Clinical significance: Use of one-layer closures may be advantageous primarily with respect to luminal diameter.