Short- and long-term survival and prevalence of postoperative ileus after small intestinal surgery in the horse.
The records of 74 horses that recovered from anaesthesia after surgery for a small intestinal lesion from 1994 to 1999 were reviewed. Sixty-three horses (85%) had a strangulating lesion and 43 of these (68%) had a resection and anastomosis. Four of 11 horses (36%) without a strangulating lesion had a resection and anastomosis. Sixty-three horses (85%) survived to discharge, with a survival rate of 53/63 in horses with a strangulating lesion (84%) and 10/11 (91%) in others. For all lesions, short-term survival for all end-to-end anastomoses (91%; 21/23) and for no resection (92%; 23/25) were superior (P < 0.05) to survival for jejunocaecal anastomosis (76%; 19/25). Fourteen horses (19%) had a repeat abdominal surgery during hospitalisation; 9 of these (64%) survived short-term. Postoperative ileus developed in 7/70 horses (10%) after surgery for a problem other than proximal enteritis, and all had a strangulating lesion. Postoperative ileus (POI) was more likely after a jejunocaecostomy than after other procedures, and did not develop after a jejunojejunostomy. Survival > 7 months was 52/69 (75%) and for > 12 months was 39/57 (68%). The estimated prevalence of adhesions was 13%. Short-term survival was poorest in horses that had a jejunocaecostomy, but long-term survival was less affected by the anastomosis used. The sharpest decline in survival was during the first postoperative week and postoperative mortality then declined over time after surgery. A postoperative protocol that allowed early postoperative feeding was well tolerated. The results confirm that the overall prognosis after small intestinal surgery in horses is improved over earlier findings.
Freeman
D E
DE
University of Illinois, College of Veterinary Medicine, 1008 West Hazelwood Dr., Urbana, Illinois 61802, USA.
Hammock
P
P
Baker
G J
GJ
Goetz
T
T
Foreman
J H
JH
Schaeffer
D J
DJ
Richter
R A
RA
Inoue
O
O
Magid
J H
JH
D000714:Anastomosis, Surgical / Q000662:veterinary; D000818:Animals; D003085:Colic / Q000401:mortality / Q000601:surgery / Q000662:veterinary*; D006734:Horse Diseases / Q000401:mortality* / Q000601:surgery*; D006736:Horses; D007077:Ileal Diseases / Q000401:mortality / Q000601:surgery / Q000662:veterinary*; D007087:Illinois / Q000453:epidemiology; D007415:Intestinal Obstruction / Q000401:mortality / Q000662:veterinary*; D011183:Postoperative Complications / Q000401:mortality / Q000662:veterinary*; D015995:Prevalence; D012720:Severity of Illness Index; D016019:Survival Analysis