Small Intestinal Anti Peristaltic Surgery to Prevent Diarrhea Associated with Total Colectomy in Dog
Dogs undergoing total colectomy have diarrhea or loose stool immediately after surgery. Intestinal anti peristaltic surgery uses the force of natural peristaltic movements of jejunum in the form of anti peristaltic movements to control this kind of post surgery diarrhea. This technique is discussed for the first time in this literature.
In this study 26 healthy, mixed breeds, aged from 8 month to 6 years olds, were selected. Six dogs were placed in control group. Total colectomy alone, was carried out in this group. In the twenty others, total colectomy plus small intestinal anti peristaltic surgery were done. After total colectomy the small intestinal anti peristaltic surgery was done in twenty dogs. In this group we removed the large intestine and made a communication between ileum and rectum. In the second step, small intestinal anti peristaltic surgery was done. In this procedure we initially selected 10 - 15 cm of jejunum and ligated the parallel appropriate vessels of the selected part of jejunum. We made two V shaped incision in the jejunum and then rotated this part of jejunum 180 degree on its self axis. Then Gambee suture for end-to-end intestinal anastomosis applied to establish a communication between two formerly distant portions of the jejunum. The entire animals in this group receive Hyoscyamine( 0.006mg/kg, every 8 hours, oral) plus Oxytetracycline (10mg/kg, every 12 hours, IM) in the three consecutive days post surgery.
In the control group 2 dogs died because of common surgery complications. Severe diarrhea, that have the most characteristics of large bowel diarrhea, observed in 4 other dogs in this group. There was no significant improvement in the severity of their diarrhea, even after 6 month of anti cholinergic therapy. In the next group that two procedures were done simultaneously, 4 dogs died because of common surgery complications. In fifteen dogs, there was an obvious improvement in the severity and duration of diarrhea, and after 2 weeks the diarrhea was completely improved. Just in one dog diarrhea was obvious after 2 weeks.
By this surgery we will convert the natural peristaltic activity of jejunum to anti peristaltic movements, also convert the anti peristaltic ones to peristaltic forms that in this situation the anti peristaltic (former peristaltic) is dominant to peristaltic. This direct force against the natural movements of small intestine is used to control the diarrhea associated with total colectomy. Our observation shows that this procedure is very effective in controlling the diarrhea; neither more complications nor undesired consequences than total colectomy alone were seen.
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