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Effects of staple size, tissue thickness, and precompression time on staple shape in side-to-side jejunocecal anastomosis in specimens obtained from healthy horses at an abattoir.

OBJECTIVE
To determine effects of staple size, precompression time, and tissue thickness on staple shape and tissue approximation in side-to-side jejunocecal anastomosis in equine specimens.


SAMPLE
Cecum, ileum, and jejunum specimens obtained from 18 healthy horses at an abattoir.


PROCEDURES
Specimens were allotted into 2 groups. Anastomoses were stapled with 4.8-or 3.8-mm staples. Precompression time was 15 seconds for both groups. Staple lines were cut into proximal, middle, and distal sections. Thickness of intestinal walls was measured with a calibrated tissue micrometer, photographs were obtained, and intestinal tissues were digested. An investigator measured staples and assessed the shape of staples on high-definition digital images. Number of optimally shaped staples and staple height were compared among sections and between groups.


RESULTS
Use of 4.8-mm staples resulted in poor approximation of tissues in the distal sections of anastomoses. The percentage of optimally shaped staples was 538 of 551 (97.6%) and 616 of 634 (97.2%) for 4.8- and 3.8-mm staples, respectively. The percentage of optimally shaped staples did not differ significantly between groups for the same sections. There was a lower percentage of optimally shaped staples in the distal sections than in the proximal and middle sections of each group. Mean staple height did not differ significantly among sections of each group.


CONCLUSIONS AND CLINICAL RELEVANCE
Use of 3.8-mm staples with an adequate precompression time for jejunocecal anastomosis in horses resulted in proper staple shape. These findings could be used to improve the technique and outcome for stapled jejunocecal anastomoses in horses.