Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 4: Early (acute) relaparotomy.
BACKGROUND
Early (acute) relaparotomy after surgery for equine colic is widely considered to be an acceptable treatment option for management of certain post operative complications. However, there is relatively little published information about resulting complication rates and short- and long-term outcomes.


OBJECTIVE
To document the proportions, indications, complication rates and survival rates of horses undergoing acute relaparatomy following colic surgery.


METHODS
History, clinical findings, surgical findings and procedures, post operative treatments and outcome of 300 consecutive surgical colic cases (1994-2001) were reviewed. Long-term follow-up information was retrieved from case records and telephone enquiries from owners.


RESULTS
Acute relaparotomy was performed in 27/254 horses (10.6%) that recovered from initial general anaesthesia. The indications for relaparotomy included persistent pain, persistent ileus, peritonitis and wound breakdown. Of these 27 horses, 21 (77.8%) recovered from the second surgery, of which 8 (29.6%) died during the immediate post operative period. Thirteen of the 27 horses (48.2%) were discharged. Of these 13 horses, 5 (38.5%) were re-admitted to the hospital for surgical treatment of a subsequent bout of colic. The long-term survival rate for the 27 horses that underwent relaparotomy was 22.2%. Colic following discharge after relaparotomy was recorded in 69.2% of cases.


CONCLUSIONS
Relaparotomy is necessary in approximately 10% of horses undergoing surgery for acute colic. Persistent pain and post operative ileus were the most common indications. The short-term survival rate for horses requiring relaparotomy was approximately 50% and the long-term survival rate 22%. Nearly 40% of horses surviving relaparotomy developed episodes of acute colic that necessitated further surgery.


CONCLUSIONS
Owners of horses requiring early (acute) relaparotomy should be advised of the high complication rates for this procedure.
Mair
T S
TS
Bell Equine Veterinary Clinic, Mereworth, Maidstone, Kent ME18 5GS, UK.
Smith
L J
LJ
D000818:Animals; D003085:Colic / Q000401:mortality / Q000601:surgery / Q000662:veterinary*; D005260:Female; D006734:Horse Diseases / Q000401:mortality* / Q000601:surgery; D006736:Horses; D045823:Ileus / Q000453:epidemiology / Q000401:mortality / Q000601:surgery / Q000662:veterinary; D007421:Intestine, Small / Q000473:pathology; D007813:Laparotomy / Q000401:mortality / Q000706:statistics & numerical data / Q000662:veterinary*; D008297:Male; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery / Q000662:veterinary*; D012008:Recurrence; D012086:Reoperation / Q000401:mortality / Q000706:statistics & numerical data / Q000662:veterinary; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome