Comparison of three suture techniques for anastomosis of the small intestine in the horse.

Seven horses were used to compare the Gambee, the crushing, and a 2-layer inverting suture pattern composed of a simple continuous layer in the mucosa oversewn with a continuous Lembert pattern in the seromuscular layer. Horses were evaluated at 30 days for adhesion formation, lumen diameter, and quality of healing at the anastomotic sites. One horse was euthanatized 9 days after surgery after 24 hours of ileus and colic; necropsy revealed septic peritonitis and widespread adhesions. One horse had no adhesions. The remaining horses had adhesions associated with 50% of the Gambee and 50% of the crushing anastomoses. There were no adhesions related to the 2-layer inverting techniques in these 6 horses. There was no significant difference in percentage reduction of lumen diameters between the 3 techniques, and there was no evidence of chronic obstruction resulting from any of the anastomotic techniques. Histologically, the inflammatory response and fibrosis were minimal in the single layer patterns, but there was increased fibrosis and suture tract inflammation in the 2-layer inverting technique.