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Enterectomy
Synonym(s): Resection and anastomosis
Introduction
- Common surgical procedure to remove section(s) of small intestine due to damage or disease.
- Enterectomy allows complete removal of a section of small intestine that is non-viable due to trauma or disease:
- Focal ischemia.
- Perforation.
- Trauma.
- Neoplasia Alimentary tract: neoplasia
. - Intussusception Intussusception.
- Infection (bacterial, fungal or phycomycosal abscessation).
- Granulomatous or stenosed segments.
Uses
Advantages
- Treatment and/or diagnosis of underlying problem.
- Exploratory celiotomy Laparotomy: midline done simultaneously allows:
- Gross examination of intestines.
- Assessment of viability or integrity of entire intestinal tract.
Disadvantages
- Increased risk due to:
- Invasive surgical procedure.
- Anesthetic risks Anesthesia: complications - overview.
- Potential post-operative complications including dehiscence, peritonitis Peritonitis, adhesions, short-bowel syndrome, ileus Ileus, abscess stricture.
Alternative techniques
- Several techniques exist.
- Most commonly used are suture closure and functional end-to-end anastomosis with gastrointestinal anastomosis (GIA) stapling devices. Below is the description for suture anastomosis.
Time required
Preparation
- 15-30 minutes.
Procedure
- 60-90 minutes.
Decision taking
Risk assessment
- Radiographs to assess for obstructive pattern. Ultrasound depending on experience for further localization of obstruction and characterization as well as free fluid in abdomen. CT Computed tomography (CT) has been shown to be rapid and accurate for the diagnosis of intestinal obstruction Intestine: obstruction.
- If free abdominal fluid perform abdominocentesis Abdominocentesis for cytology, lactate and glucose measurements.
- In some cases, hematology, biochemistry Blood biochemistry: overview, electrolytes and blood gasses are indicated.
- If the animal is unstable and/or GI perforation is suspected/confirmed, stabilize patient for shock.
Requirements
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Preparation
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Technique
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Aftercare
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Mullen K M et al (2021) Evaluation of intraoperative leak testing of small intestinal anastomoses performed by hand-swen and stapled techniques in dogs: 131 cases (2008-2019). JAVMA 258 (9), 991-998 PubMed.
- Winter M D et al (2017) Ultrasonographic and computed tomographic characterization and localization of suspected mechanical gastrointestinal obstruction in dogs. JAVMA 251 (3), 315-321 PubMed.
Other sources of information
- Giuffrida M A & Brown D C (2017) Small Intestine. In: Veterinary Surgery Small Animal. 2nd edn. Eds: Johnston S A, Tobias K M. Elsevier, USA. pp 1730-1761.