Veterinary surgery : VS · 2023
Ex vivo evaluation of a novel suture loop method for equine intestinal biopsies.
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Munsterman Amelia S, VanderBroek Ashley R, Kottwitz Jack J, Watson Victoria E
Аннотация
OBJECTIVE: To compare a novel suture loop method for intestinal biopsies (SLB) with a two-layer, hand-sutured biopsy (HSB) technique in equine small and large intestines.
STUDY DESIGN: Experimental, randomized, ex vivo study.
ANIMALS: Eight healthy adult horses.
METHODS: The duodenum, aboral jejunum, and ventral and dorsal large colon were harvested after euthanasia and divided into three sections each. The sections were randomized to SLB, HSB, or control (C, no biopsy) groups. Tissue samples were excised after placement of a suture loop formed by a 4S Roeder knot and oversewn with a Cushing pattern using barbed suture (SLB), or a simple continuous pattern oversewn with a Cushing pattern (HSB). Intraluminal diameter was assessed with contrast radiographs; bursting pressure and wall tension were determined using a solid-state sensor after instillation of fluid. Tissue samples were evaluated by a board-certified pathologist.
RESULTS: Tissue samples were full thickness with similar depth and quality (p > .3). Changes in intraluminal diameter did not differ between methods (p > .16). The bursting pressures were higher for controls than biopsied sections (p < .009) but were not different between biopsy methods (p = .998). Bursting wall tension was higher for controls (p < .02) and was similar for both biopsy methods (p = .852).
CONCLUSION: The SLB was equivalent to HSB in strength and effect on intraluminal diameter. The HSB samples were larger and more likely to contain mucosa/villi for histologic diagnosis.
CLINICAL SIGNIFICANCE: The SLB method can be adapted for laparoscopic surgery to obtain both small and large intestinal biopsies. Further investigation is needed before clinical use.
STUDY DESIGN: Experimental, randomized, ex vivo study.
ANIMALS: Eight healthy adult horses.
METHODS: The duodenum, aboral jejunum, and ventral and dorsal large colon were harvested after euthanasia and divided into three sections each. The sections were randomized to SLB, HSB, or control (C, no biopsy) groups. Tissue samples were excised after placement of a suture loop formed by a 4S Roeder knot and oversewn with a Cushing pattern using barbed suture (SLB), or a simple continuous pattern oversewn with a Cushing pattern (HSB). Intraluminal diameter was assessed with contrast radiographs; bursting pressure and wall tension were determined using a solid-state sensor after instillation of fluid. Tissue samples were evaluated by a board-certified pathologist.
RESULTS: Tissue samples were full thickness with similar depth and quality (p > .3). Changes in intraluminal diameter did not differ between methods (p > .16). The bursting pressures were higher for controls than biopsied sections (p < .009) but were not different between biopsy methods (p = .998). Bursting wall tension was higher for controls (p < .02) and was similar for both biopsy methods (p = .852).
CONCLUSION: The SLB was equivalent to HSB in strength and effect on intraluminal diameter. The HSB samples were larger and more likely to contain mucosa/villi for histologic diagnosis.
CLINICAL SIGNIFICANCE: The SLB method can be adapted for laparoscopic surgery to obtain both small and large intestinal biopsies. Further investigation is needed before clinical use.