CLINICAL COMPARISON BETWEEN A SKIN-STAPLED AND A CONTINUOUS LEMBERT PATTERN FOR JEJUNOJEJUNAL END-TO-END ANASTOMOSIS IN HORSES

Background:One-layer jejunojejunal anastomosis isconsidered effective in horses. Several patterns have beenproposed but rarely compared clinically.Objectives:The objective of the study was to compareoutcome and complications of a modified skin stapled and acontinuous Lembert pattern in jejunojejunal anastomosis inhorsesMethods:Data from clinical records of 24 horses thatunderwent jejunojejunostomy between January 2018 andJanuary 2021 at the University of Turin VTH were retrieved.Short-term complications, short- and long-term survival (>9months) were compared after a modified skin stapled (12horses with strangulating lesions, 1 with non-strangulatinglesion), and a continuous Lembert pattern (10 horses withstrangulating lesions, 1 with non-strangulating lesion).Results:Post-operative reflux (POR) developed in 9 horses, 6with the continuous Lembert and 3 with the skin stapledanastomosis. POR in the continuous Lembert group wascaused by obstructive adhesions found at necropsy (2cases), obstruction of the anastomotic site confirmed atrelaparotomy (1 case). In the skin stapled group, one of thehorses that developed POR was found having obstructiveadhesions at necropsy but not involving the anastomosis.Short-term survival was 85% (11/13) for skin stapledanastomosis, and 72% (8/11) for the continuous Lembertpattern. Long-term survival (>9 months) was 100% for skinstapled anastomosis, and 90.9% for continuous Lembertpattern.Conclusions:Both patterns performed well in clinical use,although the Lembert continuous pattern has a higher risk ofdeveloping POR.