Ralphs SC, Jessen CR, Lipowitz AJ. Risk factors for leakage following intestinal anastomosis in dogs and cats: 115 cases (1991–2000). J Am Vet Med Assoc. 2003;223(1):73–77.
Weisman DL, Smeak DD, Birchard SJ, Zweigart SL. Comparison of a continuous suture pattern with a simple interrupted pattern for enteric closure in dogs and cats: 83 cases (1991–1997). J Am Vet Med Assoc. 1999;214(10):1507–1510.
Allen DA, Smeak DD, Schertel ER. Prevalence of small intestinal dehiscence and associated clinical factors: a retrospective study of 121 dogs. J Am Anim Hosp Assoc. 1992;28(1):70–76.
Giuffrida MAB, Brown DC. Small intestine. In: Johnston SA, Tobias KM, eds. Veterinary Surgery: Small Animal. 2nd ed. Elsevier; 2018:1730–1761.
DePompeo CM, Bond L, George YE, et al. Intra-abdominal complications following intestinal anastomoses by suture and staple techniques in dogs. J Am Vet Med Assoc. 2018;253(4):437–443.
Ellison GW, Case JB, Regier PJ. Intestinal surgery in small animals: historical foundations, current thinking, and future horizons. Vet Surg. 2019;48: 1171–1180.
Radlinksy MA, Fossum TW. Surgery of the digestive system. In: Fossum TW, ed. Small Animal Surgery. 5th ed. Elsevier; 2019:331–511.
Smeak D. Enterotomy. In: Monnet E, Smeak D, eds. Gastrointestinal Surgical Techniques in Small Animals. John Wiley & Sons Inc; 2020:181–186.
Brown DC. Small intestines. In: Slatter DH, ed. Textbook of Small Animal Surgery. 3rd ed. WB Saunders; 2003:644–664.
Ellison G. Intestines. In: Bojrab MJ, Ellison GW, Slocum B, eds. Current Techniques in Small Animal Surgery. 4th ed. Williams & Wilkins; 1998:245–286.
Yool DA. Gastrointestinal surgery. In: Yool DA, ed. Small Animal Soft Ttissue Surgery. CABI; 2012:171–204.
Pavletic MM, Berg J. Gastrointestinal surgery. In: Lipowitz A, Caywood D, Newton C, Schwartz A, eds. Complications in Small Animal Surgery. Williams & Wilkins; 1996:365–398.
Culbertson TF, Smeak DD, Pogue JM, Vitt MA, Downey AC. Intraoperative surgeon probe inspection compared to leak testing for detecting gaps in canine jejunal continuous anastomoses: A cadaveric study. Vet Surg. 2021;50(7):1472–1482. Abstract. doi:10.1111/vsu.13708
Gilbert JM, Trapnell JE. Intraoperative testing of the integrity of left-sided colorectal anastomoses: a technique of value to the surgeon in training. Ann R Coll Surg Engl. 1988;70(3):158–160.
Wheeler JM, Gilbert JM. Controlled intraoperative water testing of left-sided colorectal anastomoses. Ann R Coll Surg Engl. 1999;81(2):105–108.
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(7):900–903.
Matz BM, Boothe HW, Wright JC, Boothe DM. Effect of enteric biopsy closure orientation on enteric circumference and volume of saline needed for leak testing. Can Vet J. 2014;55(1):1255–1257.
Brand KJ, Hess E, Risselada M. Effects of needle gauge and syringe size on small intestinal leakage at injection sites. Vet Surg. 2019;48(7):1237–1244.
Strelchik A, Coleman MC, Scharf VF, Stoneburner RM, Thieman Mankin KM. Intestinal incisional dehiscence rate following enterotomy for foreign body removal in 247 dogs. J Am Vet Med Assoc. 2019;(6)255:695–699.
Wylie KB, Hosgood G. Mortality and morbidity of small and large intestinal surgery in dogs and cats: 74 cases (1980–1992). J Am Anim Hosp Assoc. 1996;30(5):469–474.
Duell JR, Thieman Mankin KM, Rochat MC, Regier PJ, Singh A. Frequency of dehiscence in hand-sutured and stapled intestinal anastomoses in dogs. Vet Surg. 2016;45(1):100–103.
Delaney F, O’Brien R, Waller K. Ultrasound evaluation of small bowel thickness compared to weight in normal dogs. Vet Radiol Ultrasound. 2003;44(5):577–580.
Gladwin NE, Penninck DG, Webster CRL. Ultrasonographic evaluation of the thickness of the wall layers in the intestinal tract of dogs. Am J Vet Res. 2014;75(4):349–353.
Paulsen DB, Buddington KK, Buddington RK. Dimensions and histologic characteristics of the small intestine of dogs during postnatal development. Am J Vet Res. 2003;64(5):618–626.
Sarría R, Latorre R, Henroteaux M, et al. Morphometric study of the layers of the canine small intestine at five sampling sites. Vet J. 2012;192(3):498–502.
Mean difference for Sample Size and Power Calculations. OpenEpi: Open Source Epidemiologic Statistics for Public Health. Accessed Feb 2, 2019. https://www.openepi.com/power/powermean
Mullen KM, Regier PJ, Fox-Alvarez WA, Case JB, Ellison GW, Colee J. Evaluation of intraoperative leak testing of small intestinal anastomoses performed by hand-sewn and stapled techniques in dogs: 131 cases (2008–2019). J Am Vet Med Assoc. 2021;258(9):991–998.
Sumner SM, Regier PJ, Case JB, Ellison GW. Evaluation of suture reinforcement for stapled intestinal anastomoses: 77 dogs (2008–2018). Vet Surg. 2019;48(7):1188–1193.
White RN. Modified functional end-to-end stapled intestinal anastomosis: technique and clinical results in 15 dogs. J Small Anim Pract. 2008;49(6):274–281.
Lorange M, Smeak DD. Comparison of a simple continuous vs simple interrupted suture pattern for repair of large, open duodenal defect with jejunal serosal patch in canine cadaveric model. Am J Vet Res. 2020;81(12):985–991.
Mullen KM, Regier PJ, Waln M, Fox-Alvarez WA, Colee J. Gastrointestinal thickness, duration, and leak pressure of six intestinal anastomoses in dogs. Vet Surg. 2020;49(7):1315–1325.
Hall J. Excitation and contraction of smooth muscle. In: Hall J, ed. Textbook of Medical Physiology. 12th ed. Saunders Elsevier; 2011:91–98.
Schulze-Delrieu K. Intrinsic differences in the filling response of the guinea pig duodenum and ileum. J Lab Clin Med. 1991;117(1):44–50.
Zhao J, Liao D, Yang J, Gregersen H. Viscoelastic behavior of small intestine in streptozotocin-induced diabetic rats. Dig Dis Sci. 2003;48(12):2271–2277.
Panda SK, Buist ML. A viscoelastic framework for inflation testing of gastrointestinal tissue. J Mech Behav Biomed Mater. 2020;103:103569. doi:10.1016/j.jmbbm2019.103569
Beard JD, Nicholson ML, Sayers RD, Lloyd D, Everson NW. Intraoperative air testing of colorectal anastomoses: a prospective, randomized trial. Br J Surg. 1990;77(10):1095–1097.
Chu KL, Duffy DJ, Vieson MD, Moore GE. Ex vivo comparison of leakage pressures and leakage location with a novel technique for creation of functional side-to-side canine small intestinal anastomoses. Vet Surg. 2020;49(5):1024–1034.
Duffy DJ, Chang YJ, Moore GE. Influence of closure technique on leakage pressures in an ex vivo canine typhlectomy model. Vet Surg. 2020;49(6):1213–1220.
Duffy DJ, Moore GE. Influence of oversewing the transverse staple line during functional end-to-end stapled intestinal anastomoses in dogs. Vet Surg. 2020;49(6):1221–1229.
Kieves NR, Krebs AI, Zellner EM. A comparison of ex vivo leak pressures for four enterotomy closures in a canine model. J Am Anim Hosp Assoc. 2018;54(2):71–76.
Mutascio LM, Breur GJ, Moore GE, Simons MC. Effects of surgical sealant on leakage pressure and circumference of fresh canine cadaver small intestinal anastomoses. Am J Vet Res. 2018;79(12):1335–1340.
Aeschlimann KA, Mann FA, Middleton JR, Belter RC. Comparison of enterotomy leak pressure among fresh, cooled, and frozen-thawed porcine jejunal segments. Am J Vet Res. 2018;79(5):576–580.
Hansen LA, Smeak DD. In vitro comparison of leakage pressure and leakage location for various staple line offset configurations in functional end-to-end stapled small intestinal anastomoses of canine tissues. Am J Vet Res. 2015;76(7):644–648.
Shikata J, Shida T, Amino K, Ishioka K. Experimental studies on the hemodynamics of the small intestine following increased intraluminal pressure. Surg Gynecol Obstet. 1983;156(2):155–160.
Ellison GW. Intestinal obstruction. In: Bojrab M, Monnet E, eds. Mechanisms of Disease in Small Animal Surgery. 3rd ed. Teton NewMedia; 2010:183–187.
Tasaka K, Farrar J. Intraluminal pressure of the small intestine of the unanesthetized dog. Pflugers Arch. 1976;364(1):35–44.
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(3):370–373.
Chiba T, Sarr MG, Kendrick ML, et al. Limitations of implantable, miniature ultrasonic transducers to measure wall movement in the canine jejunum. J Surg Res. 2004;116(2):219–226.
Smith S, McGeehin W, Kozol RA, Giles D. The efficacy of intraoperative methylene blue enemas to assess the integrity of a colonic anastomosis. BMC Surg. 2007;7:15. doi:10.1186/1471-2482-7-15
Allaix ME, Lena A, Degiuli M, et al. Intraoperative air leak test reduces the rate of postoperative anastomotic leak: analysis of 777 laparoscopic left-sided colon resections. Surg Endosc. 2019;33(5):1592–1599.
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To compare the volume of saline (0.9% NaCl) solution required to reach a maximum intraluminal peristaltic pressure of 25 mm Hg in dogs of various sizes.
25 grossly normal jejunal segments from 6 canine cadavers < 20 kg (small dogs) and 25 segments from 5 cadavers ≥ 20 kg (large dogs).
Jejunal specimens were obtained within 1.5 hours after euthanasia. Harvested tissue was transected into 12-cm-long segments, mesentery was trimmed, and each segment was measured from the antimesenteric to mesenteric serosal edges. A 10-cm segment was isolated with Doyen forceps, securing a pressure sleeve within the lumen. Intraluminal saline was infused, and the volume was recorded when a pressure of > 25 mm Hg was achieved. Data were analyzed only from specimens in which the pressure remained between 24 and 26 mm Hg for > 5 seconds.
Mean ± SD intestinal measurement for large dogs (17.82 ± 1.44 mm) was greater than that for small dogs (12.38 ± 1.38 mm) as was the volume of saline solution infused (17.56 ± 7.17 mL vs 3.28 ± 1.41 mL, respectively). The volume infused increased by 1.31 mL (95% CI, 1.08 to 1.18) for every 1-mm increase in intestinal measurement and by 1.06 mL (95% CI, 1.052 to 1.068) for every 1-kg increase in body weight.
The volume of saline solution used for intestinal leak testing should be determined on the basis of patient intestinal measurement or body weight. In vivo studies are necessary to establish the optimal volume for intestinal leak testing.