Comparison of Simple Interrupted Approximating Suture with Single Layer Continuous Connell Suture in End-to-end Intestinal Anastomosis of Dogs

개의 단단장문합술에서 단순결절접합봉합과 단층연속코넬봉합의 비교

  • 이충헌 (전남대학교 수의과대학) ;
  • 신영규 (전남대학교 수의과대학) ;
  • 정순옥 (건국대학교 수의과대학) ;
  • 이채용 (전남대학교 수의과대학)
  • Published : 2001.06.01

Abstract

The purpose of this study is to know whether single layer continuous connell suture is an acceptable alternative to simple interrupted approximating suture for end-to-end intestinal anastomosis in dogs. Fourteen mixed-breed dogs weighing 2 to 5 kg were allotted to group treated with simple interrupted approximating suture (Group I) and group treated with single layer continuous Connell suture (Group II), each of 7 dogs. All dogs in each suture pattern were compared with time for total operation ad suture elapsed for intestines to anastomose, clinical signs, changing of pre-and postoperative luminal size, status of feces, adhesion at anastomotic site for 14 days after operation. Time for total operation and suture time for intestinal anastomosis were none significant between Group I and Group II, although those in Group II was about 3 minutes shorter than those in Group I, respectively. Group I spent average 47.08${\pm}$11.10 minutes on total operation, 20.97${\pm}$5.54 minutes on suture time for intestinal anastomosis and Group II spent average 44.74${\pm}$7.77 minutes, 17.73${\pm}$3.05 minutes, respectively. All dogs were no special differences in vitality, vomiting, appetite between Group I and Group II for 14 days after operation. All dogs, except one dog in Group I, had showed normal vitality and appetite since 6~8 days after operation. Initial return of fecal passage showed in all dogs before 6 days after operation and thereafter most dogs showed normal feces. According to results, it was thought that all dogs with normal vitality and appetite before 8 days had showed good prognosis. There were no changes of intestinal luminal size in 2 dogs performed Group In and one dog performed Group II between at operation and 14 days after operation. Narrowing rate of intestinal lumen in Group I was average 9.3% of the normal diameter, whereas in Group II, 9.5% of normal diameter. In complications after operation, only one dog in Group I showed intestinal intussusception but the others didn't. Length of adhesion was measured between intestinal anastomotic site and omental graft. Length of adhesion in dogs performed Group II was mostly shorter than that of Group I. Adhesion with proximate intestines occurred in five dogs, which consisted of 3 dogs performed Group I and 2 dogs performed Group II. Concurrently, they had a great length of adhesion between anastomotic site and omental graft. There were no great differences between Group I and Group II about speed of operation, clinical signs, complications such as leakage and stricture. And all dogs performed intestinal anastomosis showed good clinical condition and prognosis. In conclusion, Single layer continuous Connell suture can safely perform an intestinal anastomosis and be an alternative of simple interrupted approximating suture in aspect of speed clinically.

Keywords

References

  1. J Am Anim Hosp Assoc v.28 Prevalence of small intestinal dehiscence and associated clinical factors: A retrospective sytudy of 121 dogs Allen DA:Smeak DD;Schertel ER
  2. Am J Vet Res v.44 Evaluation of anastomoses of small intestine in dogs: Crushing versus noncrushing suturing techniques Bone RL;Duckett KE;Patton CS;Krahwinkel DJ
  3. Br J Surg v.72 Use of a single layer extranucosal suture for intestinal anastomosis in children Brain AJL;Kiely EM
  4. Vet Sur v.20 A comparison of surgical training with live anesthetized dogs and cadavers Carpenter LG;Piermattei DL;Sallman MD(et al.)
  5. Br J Surg v.78 Extramucosal technique for intestinal anastomosis Carty NJ;Keating J;Campbell J(et al.)
  6. Vet Surg v.20 Partial gastrectomy with an automatic stapling instrument for treatment of gastric necrosis secondary to gastric dilatation-volvulus Clark GN;Pavletic MM
  7. Atlas of general small animal surgery of the dog and cat(1st ed) Caywood DD;Lipoqitz AJ
  8. J Am Anim Hosp Assoc v.9 Simple interrupted approximating techique for intestinal anastomosis Dehoff WD;Nelson W;Lumb WV
  9. Current techniques in small animal surgery(4th ed.) Intestinal resection and anastomosis Ellison GW;Bojrab MJ;Birchard SJ;Tomlinson J
  10. Sugical forum American college of surgeons(1st ed.) Suture strength and healing strength of end-to-end intestinal anastomoses Fellows NM;Burge J;Hatch S(et al.)
  11. Small annimal surgery(1st ed.) Surgery of the small intestine Fossum TW;Hedlund CS;Hulse DA(ed al.)
  12. Br Med J v.286 Intestinal anastomosis Gillesp IE
  13. Atlas of small animal surgery(1st ed.) Gourley IM;Cregory CR
  14. J Am Vet Med Assoc v.191 Open peritoneal drainage for treatment of contaminated perioneal cavity and septic peritonitis in dogs and cats: 24 cases(1980-1986) Greenfield CL;Walshaw R
  15. A small animal surgery(1st ed.) The small and large intestine Harvey HJ:Harvey CE(ed.);Newton CD(ed.);Schwartz A(ed.)
  16. Veterinary surgery(3rd ed.) Gastro-intestinal sugery Hickman J;Houlton JFE;Edwards B
  17. J Am Anim Hosp Assoc v.8 Simple interrupted crushing suture for intestinal anastomosis: a case report Hinko PJ;Rickards CA;Morse SM
  18. Inter Surg v.62 Beneficial effect of omental wrapping of unsafe intestinal anastomoses Katsikas D;Sechas M;Antypas G(etc.)
  19. Surg Gynecol Obster v.153 Single layer intestinal anastomosis Kratzer GL
  20. Experimental surgery(5th ed.) Standard procedures in surgery of the alimentary canal Makowitz J;Archibald J;Doronie HG
  21. Am J Sur v.162 Results of 1,000 single-layer continuous polypropylene intestinal anastomoses Max E;Sweeney W.B;Bailey H.R(etc.)
  22. J Am Vel Med Assoc v.184 Intramural intestinal hematoma causing obstruction in three dogs Moore R;Carpenter J
  23. Dis Colon Rectum v.42 Use of the greater omentum in colorectal surgery O'Leary DP
  24. Texbook of Small animal surgery(2nd ed.) Small intestine Orcher R;Rosin E; Slatter D(ed.)
  25. J Pediatr Surg v.33 Intestinal anastomosis in children: a comparative study between two different techniques Ordorica-Flores RM;Bracho-Blanchet E(et al.)
  26. Complication in small animal surgery(1st ed.) Gastrointestinal surgery Palvletic MM;Berg J;Lipowitz AJ(ed.);Caywood KK(ed.);Newton CD(ed.);Schwartz A(ed.)
  27. Am J Vet Res v.43 Colonic anastomosis: Evaluation of an 'end-to-end' crushing and inverting technique Richardson DC;Duckett KE;Krahwinkel DJ;Shipman LW
  28. J Surg Res v.81 Intesitnal sleeve anstomosis: A comparative study with end-do-end anastomosis Rieger N;Slaven JL;Keck J(et al.)
  29. Vet Rec v.24 Intestinal anastomosis Rigby JP
  30. Principles of Surgery(6th ed.) Small intestine Schwartz SI;Spencer FC;Shires GT
  31. Decision making in small animal soft tissue surgery(1st ed.) Obstruction of the small intestine Seim HB;Bennington AG(ed.);Cockshutt JR(ed.)
  32. Saunder manual of small animal practice(1st ed.) Diseases of the intestine Sherding RG;Johnson SE;Birchared SJ(ed.);Sherding RG(ed.)
  33. Atlas of approaches of general surgery of the dog and cat(1st ed.) Smith MM
  34. Small animal surgery(1st ed.) Alimentary system Tobias KS;Harari J(ed.)
  35. Vet Sur v.20 Open intestinal anastomosis with surgical stapling equipment in 24 dogs and cats Ullman SL;Pavletic MM;Clark GN
  36. BSAVA manual of caninc and feline gastroenterology(1st ed.) Surgical management of conditions of gastrointestinal tract and associated glands Wlliams J;Thomas D(ed.);Simpson JW(ed.);Hall EJ(d.)
  37. J Am Vet Med Assoc v.164 lntussusception in the dog and cat: A rcview of 45 cases Wilson GP;Burt JK
  38. Vet Sur v.21 Short bowel syndrome in four dogs Wanoff SR;Willard MD;Boothe HW;Walker M
  39. J Am Vet Med Assoc v.214 Comparison of a continuous suture pattern with a simple interrupted pattern for enteric closure in dogs and cats: 83 cases(1991-1997) Weisman DL;Smeak DD;Birchard SJ(et al.)
  40. Ann Sur v.227 Intraperitoneal sodium carboxymethylcellulose administration prevents reformation of peritoneal adhesions following surgical lysis Wurster SH;Bonet V;Mayberry A(et al.)
  41. 한국임상수의학회지 v.16 개에서 Sodium carboxymethylcellulose와 low molecular weight heparin의 유착방지효과 권영삼;장인호
  42. 한국임상수의학회지 v.10 염소의 제1위 복벽유착의 진단 및 예방에 관한 연구 정종태;권오경;남치주