Long‐term survival in horses with strangulating obstruction of the small intestine managed without resection

Abstract

A subjective method of assessing small intestinal viability in strangulated small intestine in horses, as used in this study, could reduce the need for resection and anastomosis, with the associated complications and costs. Also, the favourable post operative course in these horses provides strong evidence that early referral could avoid the need for resection and improve survival. The numbers of horses with the most severe changes that were not resected were too small to allow a conclusion that such segments should be left in place, and additional criteria might be needed to guide that decision in such cases.

Long-term follow-up on recovery, return to use and sporting activity: a retrospective study of 236 operated colic horses in Finland (2006–2012)

“…Long-term retrospective studies are challenging as from 14 to 44% of the horses are lost to follow-up [2, 7, 14–16]. Missing data and small study population sizes may cause bias in statistical analysis and interpretation of results.…”

“…Additionally, there are only two 24-h equine emergency hospitals in the southern part of Finland. This might cause delays in the initiation of the treatment, which worsens short- and long-term prognosis for colic patients [14, 16, 17, 19]. …”

“…Postoperative colic is reported by several other studies to be the most common long-term complication after colic surgery, documented in between 11 and 35% of the patients, which is a negative factor for postoperative survival [1–4, 14, 17, 19, 20]. A study by Tinker and colleagues [21] reported the incidence of colic in a large population of horses that had not had colic surgery, to vary between 0 and 30%.…”

Indications, complications, and outcome of horses undergoing repeated celiotomy within 14 days after the first colic surgery: 95 cases (2005–2013)

“…It is possible that the cumulative trauma of 2 surgeries in close succession, in conjunction with intestinal compromise, added to the risk of adhesion formation and ultimately affected long-term survival rate. Whether a subjective grading system for intestinal viability 25 could reduce the need for intestinal resection and positively influence long-term outcome remains unknown. Interestingly, few horses that survived to > 6 months after hospital discharge developed recurrent colic episodes or any other compromise of well-being.…”

Evaluation and graduation of histomorphological changes in ischemic small or large intestine regions after strangulation – a field study

“…Intraoperativ entscheidet der Chirurg anhand von Darmwandfarbe, -dicke und -motilität, Länge des betroffenen Darmteils und Lokalisation der Strangulation, ob eine Resektion erfolgversprechend ist (Freeman et al 2014). Trotz dieser vielen prognostischen Faktoren gibt es hinsichtlich der Interpretation der Darmvitalität viele Grenzfälle, bei denen makroskopisch keine eindeutige Prognosestellung möglich ist.…”