Korean Journal of Veterinary Research (대한수의학회지)

The Korean Society of Veterinary Science (대한수의학회)
권호 표지
DOI QR코드

DOI QR Code

A comparison of leak pressures between esophageal to esophageal anastomosis and esophageal to jejunal anastomosis

  • Cunningham, Devin P. (Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri) ;
  • Middleton, John R. (Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri) ;
  • Mann, F.A. (Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri)
  • Received : 2018.10.18
  • Accepted : 2019.03.07
  • Published : 2020.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

The goal of this study was to determine if there was a difference in leak pressure between esophageal-esophageal anastomosis and esophageal-jejunal anastomosis when using cadaveric porcine tissue. Leak pressures were recorded for esophageal-esophageal anastomosis (Group 1 [control group], n = 7), cranial esophageal-jejunal anastomosis (Group 2, n = 7), and jejunal-caudal esophageal anastomosis (Group 3, n = 6). Each anastomosis was performed using polydioxanone sutures in a simple interrupted pattern. Results were analyzed using one-way analysis of variance. Mean ± SD of the leak pressures for groups 1, 2, and 3 were 46.1 ± 15.9, 36.5 ± 13.6, and 50.9 ± 11.1 mmHg, respectively (p = 0.18). When the results from groups 2 and 3 were combined and compared to that for Group 1, the mean ± SD leak pressures were 46.1± 15.9 and 43.1± 14.2 mmHg, respectively (p = 0.67). These results provide preliminary evidence that the jejunum may be a suitable option for use in esophageal replacement surgery; however, future studies of in vivo factors influencing the integrity of esophageal-jejunal anastomoses, including histologic evaluation of esophageal-jejunal anastomosis healing, are needed.

Keywords

References

  1. Hedlund CS. Surgery of the Esophagus. In: Fossum TW (ed.). Small Animal Surgery. 3rd ed. pp. 372-409, Mosby Elsevier, St. Louis, 2007.
  2. Hoffer RE. Principles of Esophageal Surgery. In: Slatter DH (ed.). Textbook of Small Animal Surgery. pp. 654-679, WB Saunders Co., Philadelphia, 1985.
  3. Kieves NR, Krebs AI, Zellner EM. A comparison of ex vivo pressures for four enterotomy closures in a canine model. J Am Anim Hosp Assoc 2018;54:71-76. https://doi.org/10.5326/JAAHA-MS-6459
  4. Waldron DR. Cervical and Thoracic Esophageal Resection and Anastomosis. In: Bojrab MJ (ed.). Current Techniques in Small Animal Surgery. 2nd ed. pp. 133-140, Lea and Febiger, Philadelphia, 1983.
  5. Bouayad H, Caywood DD, Alyakine H, Lipowitz AJ, Liepold HW. Surgical reconstruction of partial circumferential esophageal defect in the dog. J Invest Surg 1992;5:327-342. https://doi.org/10.3109/08941939209012450
  6. Flanders JA. Problems and complications associated with esophageal surgery. Probl Vet Med 1989;1:183-194.
  7. Gregory CR, Gourley IM, Bruyette DS, Schultz LJ. Free jejunal segment for treatment of cervical esophageal stricture in a dog. J Am Vet Med Assoc 1988;193:230-232.
  8. Pavletic MM. Reconstructive esophageal surgery in the dog: a literature review and case report. J Am Anim Hosp Assoc 1981;17:435-444.
  9. Renberg W, Waldron DR. Esophagus. In: Bojrab MJ, Slocum B, Ellison GW (eds.). Current Techniques in Small Animal Surgery. 4th ed. pp. 187-204, Williams and Wilkins, Baltimore, 1998.
  10. Sutton JS, Culp WT, Scotti K, Seibert RL, Lux CN, Singh A, Wormser C, Runge JJ, Schmiedt CW, Corrie J, Phillips H, Selmic LE, Nucci DJ, Mayhew PD, Kass PH. Perioperative morbidity and outcome of esophageal surgery in dogs and cats: 72 cases (1993-2013). J Am Vet Med Assoc 2016;249:787-793. https://doi.org/10.2460/javma.249.7.787
  11. Oakes MG, Hosgood G, Snider TG 3rd, Hedlund CS, Crawford MP. Esophagotomy closure in the dog. A comparison of a double-layer appositional and two single-layer appositional techniques. Vet Surg 1993;22:451-456. https://doi.org/10.1111/j.1532-950X.1993.tb00421.x
  12. Runge JJ, Culp WT. Surgical Treatment of Esophageal Disease In: Monet E (ed.). Small Animal Soft Tissue Surgery. pp. 204-320, John Wiley & Sons, Hoboken, 2013.
  13. Davenport M, Hosie GP, Tasker RC, Gordon I, Kiely EM, Spitz L. Long-term effects of gastric transposition in children: a physiological study. J Pediatr Surg 1996;31:588-593. https://doi.org/10.1016/S0022-3468(96)90503-5
  14. Linder PA, Sugarbaker DJ. Surgical Procedures to Resect and Replace the Esophagus. In: Zinner M, Ashley SW (eds.). Maingot's Abdominal Operations. 11th ed. pp. 305-330, MacGraw-Hill, Columbus, 2007.
  15. Meyers WC, Seigler HF, Hanks JB, Thompson WM, Postlethwait R, Jones RS, Akwari OK, Cole TB. Postoperative function of "free jejunal transplants for replacement of the cervical esophagus. Ann Surg 1980;192:439-450. https://doi.org/10.1097/00000658-198010000-00002
  16. Muangsombut J, Hankins JR, Mason GR, McLaughlin JS. The use of circular myotomy to facilitate resection and endto-end anastomosis of the esophagus. An experimental study. J Thorac Cardiovasc Surg 1974;68:522-529. https://doi.org/10.1016/S0022-5223(19)39850-2
  17. Rodgers BM, Talbert JL, Moazam F, Felman AH. Functional and metabolic evaluation of colon replacement of the esophagus in children. J Pediatr Surg 1978;13:35-39. https://doi.org/10.1016/S0022-3468(78)80209-7
  18. Wilkins EW Jr. Long-segment colon substitution for the esophagus. Ann Surg 1980;192:722-725. https://doi.org/10.1097/00000658-198012000-00005
  19. Kuzma AB, Holmberg DL, Miller CW, Barker I, Roth J. Esophageal replacement in the dog by microvascular colon transfer. Vet Surg 1989;18:439-445. https://doi.org/10.1111/j.1532-950X.1990.tb01122.x
  20. Bax KM. Jejunum for bridging long-gap esophageal atresia. Semin Pediatr Surg 2009;18:34-39. https://doi.org/10.1053/j.sempedsurg.2008.10.007
  21. Cauchi JA, Buick RG, Gornall P, Simms MH, Parikh DH. Oesophageal substitution with free and pedicled jejunum: short- and long-term outcomes. Pediatr Surg Int 2007;23:11-19. https://doi.org/10.1007/s00383-006-1770-0
  22. Ring WS, Varco RL, L'Heureux PR, Foker JE. Esophageal replacement with jejunum in children: an 18 to 33 year followup. J Thorac Cardiovasc Surg 1982;83:918-927. https://doi.org/10.1016/S0022-5223(19)37190-9
  23. Shieh HF, Jennings RW. Long-gap esophageal atresia. Semin Pediatr Surg 2017;26:72-77. https://doi.org/10.1053/j.sempedsurg.2017.02.009
  24. Curran KM, Fransson BA, Gay JM. A comparison of in situ and in vitro techniques for bursting pressure testing of canine jejunum. Am J Vet Res 2010;71:370-373. https://doi.org/10.2460/ajvr.71.3.370
  25. Saile K, Boothe HW, Boothe DM. Saline volume necessary to achieve predetermined intraluminal pressures during leak testing of small intestinal biopsy sites in the dog. Vet Surg 2010;39:900-903. https://doi.org/10.1111/j.1532-950X.2010.00730.x
  26. Semevolos SA, Reed SK, Gamble K. In vitro bursting pressures of jejunal enterotomy closures in llamas. Vet Surg 2007;36:64-67. https://doi.org/10.1111/j.1532-950X.2007.00236.x
  27. Evans HE, de Lahunta A. Miller's Anatomy of the Dog. Saunders/Elsevier, St. Louis, 2013.
  28. Ranen E, Shamir MH, Shahar R, Johnston DE. Partial esophagectomy with single layer closure for treatment of esophageal sarcomas in 6 dogs. Vet Surg 2004;33:428-434. https://doi.org/10.1111/j.1532-950X.2004.04062.x
  29. Nicks R. Colonic replacement of the oesophagus. Some observations on infarction and wound leakage. Br J Surg 1967;54:124-128. https://doi.org/10.1002/bjs.1800540211
  30. Kyles AE. Esophagus. In: Tobias KM, Johnston SJ (eds.). Veterinary Surgery: Small Animal. pp. 1461-1483, Elsevier, St. Louis, 2012.
  31. Bothereau H, Munoz-Bongrand N, Lambert B, Montemagno S, Cattan P, Sarfati E. Esophageal reconstruction after caustic injury: is there still a place for right coloplasty? Am J Surg 2007;193:660-664. https://doi.org/10.1016/j.amjsurg.2006.08.074
  32. Nucci DJ, Monnet E. Tissue blood flow to a pedicled jejunal autograft in the dog: a pilot study. Vet Surg 2017;46:838-842. https://doi.org/10.1111/vsu.12676
  33. Saldana-Cortes JA, Larios-Arceo F, Prieto-Diaz-Chavez E, De Buen EP, Gonzalez-Mercado S, Alvarez-Villasenor AS, Prieto-Aldape MR, Fuentes-Orozco C, Gonzalez-Ojeda A. Role of fibrin glue in the prevention of cervical leakage and strictures after esophageal reconstruction of caustic injury. World J Surg 2009;33:986-993. https://doi.org/10.1007/s00268-009-9949-x
  34. Gallo G, Zwaveling S, Van der Zee DC, Bax KN, de Langen ZJ, Hulscher JB. A two-center comparative study of gastric pull-up and jejunal interposition for long gap esophageal atresia. J Pediatr Surg 2015;50:535-539. https://doi.org/10.1016/j.jpedsurg.2014.05.026
  35. Sale CS, Williams JM. Results of transthoracic esophagotomy retrieval of esophageal foreign body obstructions in dogs: 14 cases (2000-2004). J Am Anim Hosp Assoc 2006;42:450-456. https://doi.org/10.5326/0420450
  36. Leib MS, Sartor LL. Esophageal foreign body obstruction caused by a dental chew treat in 31 dogs (2000-2006). J Am Vet Med Assoc 2008;232:1021-1025. https://doi.org/10.2460/javma.232.7.1021
  37. Eurell JA, Frappier BL. Dellmann's Textbook of Veterinary Histology. Blackwell Pub, Ames, 2007.
  38. Dyce KM, Sack WO, Wensing CJ. Textbook of Veterinary Anatomy. 4th ed. Saunders/Elsevier, St. Louis, 2010.