• 1.

    Freeman DE. Small intestine. In: Auer JA, Stick JA, eds. Equine surgery. 2nd ed. Philadelphia: WB Saunders Co, 1999;232256.

  • 2.

    Freeman DE, Hammock P, Baker GJ, et al.Short- and long-term survival and prevalence of postoperative ileus after small intestinal surgery in the horse. Equine Vet J Suppl2000;(32):4251.

    • Search Google Scholar
    • Export Citation
  • 3.

    Proudman CJ, Edwards GB, Barnes J. Different survival in horses requiring end-to-end jejunojejunal anastomosis compared to those requiring side-to-side jejunocaecal anastomosis. Equine Vet J 2007; 39:181185.

    • Search Google Scholar
    • Export Citation
  • 4.

    Bladon BM, Hillyer MH. Effect of extensive ileal resection with a large resulting mesenteric defect and stapled ileal stump in horses with a jejunocaecostomy: a comparison with other anastomotic techniques. Equine Vet J Suppl 2000; 32:5258.

    • Search Google Scholar
    • Export Citation
  • 5.

    Morton AJ, Blikslager AT. Surgical and postoperative factors influencing short-term survival of horses following small intestinal resection: 92 cases (1994-2001). Equine Vet J 2002; 34:450454.

    • Search Google Scholar
    • Export Citation
  • 6.

    Donawick WJ, Christie BA, Stewart JV. Resection of diseased ileum in the horse. J Am Vet Med Assoc 1971; 159:11461149.

  • 7.

    Rendle DI, Woodt JL & Summerhays GE, et al. End-to-end jejunoileal anastomosis following resection of strangulated small intestine in horses: a comparative study. Equine Vet J 2005; 37:356359.

    • Search Google Scholar
    • Export Citation
  • 8.

    Freeman DE. Surgery of the small intestine. Vet Clin North Am Equine Pract 1997; 13:261301.

  • 9.

    Huskamp B. Ileum-resektion und Jejunocaecostomie beim Pferd. Berl Munch Tierarztl Wochenschr 1973; 86:161163.

  • 10.

    Dabareiner RM, Sullins KE & White NA, et al. Serosal injury in the equine jejunum and ascending colon after ischemia-reperfusion or intraluminal distention and decompression. Vet Surg 2001; 30:114125.

    • Search Google Scholar
    • Export Citation
  • 11.

    Blackwell R. Jejunocecostomy in the horse: a comparison of two techniques, in Proceedings. 1st Equine Colic Res Symp1982;288289.

  • 12.

    Rocken M, Ross MW. Vergleichsstudie über die Jejunocaecos-tomie als End-zu-Seitanastomose und Seit-zu-Seitanastomose. Pferdeheilkunde 1994; 10:311315.

    • Search Google Scholar
    • Export Citation
  • 13.

    Proudman CJ, Smith JE & Edwards GB, et al. Long-term survival of equine surgical colic cases. Part 1: patterns of mortality and morbidity. Equine Vet J 2002; 34:432437.

    • Search Google Scholar
    • Export Citation
  • 14.

    Freeman DE, Schaeffer DJ, Baker GJ. A clinical grading system for intraoperative assessment of small intestinal viability in the horse, in Proceedings. 47th Annu Meet Am Assoc Equine Pract2001;105109.

    • Search Google Scholar
    • Export Citation
  • 15.

    Tinker MK, White NA & Lessard P, et al. Prospective study of equine colic incidence and mortality. Equine Vet J 1997; 29:448453.

  • 16.

    Mair TS, Smith LJ. Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 4: early (acute) relaparotomy. Equine Vet J 2005; 37:315318.

    • Search Google Scholar
    • Export Citation
  • 17.

    McIlwraith CW, Turner AS. Equine surgery advanced techniques. Philadelphia: Lea & Febiger, 1987;309314.

  • 18.

    French NP, Smith J & Edwards GB, et al. Equine surgical colic: risk factors for postoperative complications. Equine Vet J 2002; 34: 444449.

  • 19.

    Baxter GM, Broome TE, Moore JN. Abdominal adhesions after small intestinal surgery in the horse. Vet Surg 1989; 18:409414.

  • 20.

    Freeman DE. Does jejunocecostomy deserve its bad reputation? in Proceedings. Am Coll Vet Surg Vet Symp2008;7072.

  • 21.

    Huskamp B. Diagnosis and treatment of acute abdominal conditions in the horse: various types and frequency as seen at the animal hospital in Hochmoor, in Proceedings. 1st Equine Colic Res Symp1982;261272.

    • Search Google Scholar
    • Export Citation
  • 22.

    Nygaard K. Gastro-intestinal motility after resections and bypass operations on the small intestine in rats. Acta Chir Scand 1967; 133:653663.

    • Search Google Scholar
    • Export Citation

Advertisement

Comparison of complications and long-term survival rates following hand-sewn versus stapled side-to-side jejunocecostomy in horses with colic

David E. Freeman MVB, PhD, DACVS1 and David J. Schaeffer PhD2
View More View Less
  • 1 Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.
  • | 2 Department of Biosciences, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

Abstract

Objective—To evaluate survival rate and complications after jejunocecostomy in horses with colic and to compare outcomes after hand-sewn versus stapled side-to-side jejunocecostomy.

Design—Retrospective cohort study. Animals—32 horses.

Procedures—Information was retrieved from medical records and through telephone calls on horses that had a hand-sewn or stapled side-to-side jejunocecostomy for treatment of colic, which was performed by or under the supervision of the same surgeon. KaplanMeier life table analysis was used to compare survival times and rates between horses that underwent a hand-sewn or stapled side-to-side anastomosis.

Results—32 horses met inclusion criteria; 22 underwent a hand-sewn anastomosis, and 10 underwent a stapled anastomosis. Horses in the stapled group had a significantly greater prevalence of postoperative colic and combined postoperative colic and reflux than horses in the hand-sewn group. In the hand-sewn group, repeated celiotomy was performed within the same hospitalization period for 3 of 22 horses; in the stapled group, 4 of 10 horses had repeated celiotomies. Hospital discharge rates (ie, short-term survival rates) were similar between horses in the hand-sewn group (20/22 horses) and those in the stapled group (9/10 horses). Long-term survival rates were similar for both groups, ranging from 5 to 126 months. Conclusions and Clinical Relevance—Short- and long-term results justify use of jejunocecostomy in horses. Despite similar survival rates between groups, horses that underwent a stapled anastomosis had significantly greater prevalences of postoperative complications than horses that underwent a hand-sewn anastomosis, suggesting that horses were sensitive to minor differences in anastomosis techniques.

Abstract

Objective—To evaluate survival rate and complications after jejunocecostomy in horses with colic and to compare outcomes after hand-sewn versus stapled side-to-side jejunocecostomy.

Design—Retrospective cohort study. Animals—32 horses.

Procedures—Information was retrieved from medical records and through telephone calls on horses that had a hand-sewn or stapled side-to-side jejunocecostomy for treatment of colic, which was performed by or under the supervision of the same surgeon. KaplanMeier life table analysis was used to compare survival times and rates between horses that underwent a hand-sewn or stapled side-to-side anastomosis.

Results—32 horses met inclusion criteria; 22 underwent a hand-sewn anastomosis, and 10 underwent a stapled anastomosis. Horses in the stapled group had a significantly greater prevalence of postoperative colic and combined postoperative colic and reflux than horses in the hand-sewn group. In the hand-sewn group, repeated celiotomy was performed within the same hospitalization period for 3 of 22 horses; in the stapled group, 4 of 10 horses had repeated celiotomies. Hospital discharge rates (ie, short-term survival rates) were similar between horses in the hand-sewn group (20/22 horses) and those in the stapled group (9/10 horses). Long-term survival rates were similar for both groups, ranging from 5 to 126 months. Conclusions and Clinical Relevance—Short- and long-term results justify use of jejunocecostomy in horses. Despite similar survival rates between groups, horses that underwent a stapled anastomosis had significantly greater prevalences of postoperative complications than horses that underwent a hand-sewn anastomosis, suggesting that horses were sensitive to minor differences in anastomosis techniques.

Contributor Notes

Dr. Freeman's present address is Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610.

Address correspondence to Dr. Freeman (freemand@ufl.edu).