Objective—To compare the outcomes of doublelayer
inverting anastomosis (DIA), single-layer anastomosis
(SLA), and single-layer anastomosis combined
with a hyaluronate membrane (SLA+HA-membrane)
with respect to stomal diameter, adhesion formation,
surgery time, and anastomotic healing in horses.
Animals—18 adult horses.
Procedure—Midline celiotomy and end-to-end anastomoses
were performed. In control horses (n = 6),
DIA was performed; in treated horses, SLA was performed
(6) or SLA+HA-membrane was performed (6).
Horses were euthanatized 21 days after surgery.
Abdominal adhesions were evaluated grossly and histologically.
Stomal diameters were measured ultrasonographically
and compared with adjacent luminal
diameters. Anastomotic healing was evaluated histologically
for fibrosis and inflammation, tissue alignment,
and inversion. Surgery times were recorded for
the anastomotic procedure and compared among
Results—There were significantly more adhesions in
the SLA group, compared with the DIA and SLA+HAmembrane
groups. Reduction in stomal diameters in
the DIA group was significantly greater than the SLA
and SLA+HA-membrane groups. Surgery times for
the DIA group were significantly greater than the SLA
and SLA+HA-membrane groups. Histologic findings
of fibrosis, inflammation, and mucosal healing were
similar among groups. There was significant tissue
inversion in the DIA group, compared with the 2 treatment
groups. Tissue alignment was not different
Conclusions and Clinical Relevance—Use of a
SLA+HA-membrane was an effective small intestinal
anastomotic technique. This technique was faster to
perform and resulted in a larger stomal diameter,
compared with the DIA technique and significantly
fewer perianastomotic adhesions, compared with the
SLA technique. (Am J Vet Res 2001;62:1314–1319)