Use of a hyaluronate membrane for jejunal anastomosis in horses

Objective-To compare the outcomes of double-layer inverting anastomosis (DI A), single-layer anastomosis (SLA), and single-layer anastomosis combined w ith a hyaluronate membrane (SLA+HA-membrane) with respect to stomal diamete r, adhesion formation, surgery time, and anastomotic healing in horses. Animals-18 adult horses. Procedure Midline celiotomy and end-to-end anastomoses were performed. In c ontrol horses (n = 6), DIA was performed; in treated horses, SLA was perfor med (6) or SLA+HA-membrane was performed (6). Horses were euthanatized 21 d ays after surgery. Abdominal adhesions were evaluated grossly and histologi cally. Stomal diameters were measured ultrasonographically and compared wit h adjacent luminal diameters, Anastomotic healing was evaluated histologica lly for fibrosis and inflammation, tissue alignment, and inversion. Surgery times were recorded for the anastomotic procedure and compared among group s. Results-There were significantly more adhesions in the SLA group, compared with the DIA and SLA+HA-membrane groups. Reduction in stomal diameters in t he DIA group was significantly greater than the SLA and SLA+HA-membrane gro ups. Surgery times for the DIA group were significantly greater than the SL A and SLA+HA-membrane groups. Histologic findings of fibrosis, inflammation , and mucosal healing were similar among groups. There was significant tiss ue inversion in the DIA group, compared with the 2 treatment groups. Tissue alignment was not different among groups. Conclusions and Clinical Relevance-Use of a SLA+HA-membrane was an effectiv e small intestinal anastomotic technique. This technique was faster to perf orm and resulted in a larger stomal diameter, compared with the DIA techniq ue and significantly fewer perianastomotic adhesions, compared with the SLA technique.