Comparison of crushing and modified gambee techniques for intestinal anastomosis in dogs under xylazine anaesthesia

Abstract

The study was conducted on 12 apparently healthy, adult mongrel dogs of either sex, dived in to two groups viz, group I and group II, each consisting of 6 dogs.

All the animals were pre-mediacated with diazepam at the rate of 1 mg/kg bodyweight intravenous and anaesthetized with intramascular administration of xylazine hydrochloride at the rate of 2 mg/kg bodyweight.

In the animals of group I and to end intestinal anaestomosis was performed with crushing pattern of suturing and in the animals of group II end to end intestinal anastomosis was performed with modified Gambee pattern of suturing.

The anesthetic technique was satisfactory for the surgical procedure in all the animals .

The induction tome for anaesthesia was 15.50 + 1.00 minutes. THe anaesthetic effect persisted for about 48.25-1.10 minutes. The abdominal muscle relaxation and analgesic effect were found satisfactory. The recovery period was 30.00 + 1.50 minutes and was smooth and uneventful.

The time required to perform anastomosis using crushing and modified gambee techniques were 26.30 + 1.40 and 35.70 + 0.87 respectively. The average number of sutures used in both techniques were 15.

In both groups, animals well tolerated food in the immediate post-operative days. However, one animal in group I and three animals from group II, had vomition immediately after consumption of milk at 12 hours post – operatively.

Physiological and haemotological parameters did not reveal any significant variation.

In both the groups , post operative lateral and ventrodorsal radiographs showed free passage of contrast medium (Barium Sulphate) upto the terminal colon. There was no evidence of anastomotic leakage and proximal distension in both the groups.

Autopsy findings revealed that all the animals had adhesion at the anastomotic site with omentum. Adhesion to adjacent intestinal serosal surface were observed in one animal in each group .

Gross evaluation of the adominal cavity revealed a low-grade peritonitis in one animal of group I on 3rd post surgical day.

The Luminal stenosis of the anastomotic site revealed, maximum luminal stenosis (47.83%) at 7th post –operative days and minimum (21.74%) at 28th day following crushing pattern. In modified Gambee pattern, the maximum luminal stenosis (42.85%) was noticed at 5th and 7th post –operative days and minimum stenosis (7.32%) at 28th day. The luminal stenosis did not produce any clinical symptom in any of the dogs in both the groups.

Angiograms of early post – operative day (5th day) showed diffused, avascular zone at the anastomotic site in both the techniques. Eventhourgh, there was commencement of proliferation of vessels and its invasion into anastomotic site by 14th day in the crushing anastomosis, normal vascularity and its crossing over could not be observed till 28th day, where as the modified gambee anastomosis showed proliferation and crossing over of fine arterioles by 28th day.

Histological examination demonstrated that in crushing anastomosis comparatively moderate inflammatory reaction with predominance of mononuclears and few polymorphs on the 3rd day, but from 14th day there was only mild inflammatory reaction which which persisted upto 28th day.

In modified Gambee technique, only mild reaction was seen on the early post opestive days and it subsided by 21st day.

Rapid regeneration of epithelium was noticed in the modified Gambee (7th day) than the crushing technique. On the 28th day, in both the techniques all layers appeared in good apposition with proliferation of connective tissue on the muscular, subserosal and submucosal layers.