title: Differential survival in horses requiring end-to-end jejunojejunal anastomosis compared to those requiring side-to-side jejunocaecal anastomosis.
abstract: BACKGROUND
  Horses requiring different methods of intestinal anastomosis during equine colic surgery may have differences in mortality and morbidity.
  
  
  OBJECTIVE
  Horses requiring side-to-side jejunocaecal anastomosis have a higher mortality and morbidity rate than those requiring end-to-end jejunojejunal anastomosis. Morbidity and mortality of handsewn vs. stapled side-to-side jejunocaecal anastomoses are not significantly different.
  
  
  METHODS
  A prospective, nonrandomised, observational study was conducted. Clinical and surgical details were recorded during hospitalisation and survival data acquired by periodic telephone questionnaire. Differences in mortality and morbidity rate were evaluated by survival analysis.
  
  
  RESULTS
  A total of 184 horses underwent end-to-end jejunojejunal anastomosis and 178 underwent side-to-side jejunocaecal anastomosis. Horses with a jejunocaecal anastomosis had a significantly higher mortality rate. The incidence of post operative colic in horses requiring side-to-side jejunocaecal anastomoses was greater than those requiring end-to-end jejunojejunal anastomoses. Within the group undergoing side-to-side jejunocaecal anastomosis there was no evidence of differential survival between horses with handsewn vs. stapled anastomoses.
  
  
  CONCLUSIONS
  Mortality rate is higher in horses that have required side-to-side jejunocaecal anastomosis than in those that needed end-to-end jejunojejunal anastomosis; and post operative colic is more common after side-to-side jejunocaecal anastomosis. No difference in mortality was found between horses with handsewn and stapled side-to-side jejunocaecal anastomoses.
  
  
  CONCLUSIONS
  Surgeons should be aware of the increased mortality and morbidity in horses requiring side-to-side jejunocaecal anastomosis. Our finding of no difference in mortality between handsewn and stapled side-to-side jejunocaecal anastomoses justifies surgeons exercising personal preference in their selection of anastomosis method.
authors: Equine Division, Faculty of Veterinary Science, University of Liverpool, 'Leahurst', Neston, Cheshire CH64 7TE, UK.
authors: C J
authors: CJ
authors: Proudman
authors: G B
authors: GB
authors: Edwards
authors: J
authors: J
authors: Barnes
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods / Q000662:veterinary*; D000818:Animals; D002432:Cecum / Q000601:surgery*; D003085:Colic / Q000401:mortality / Q000601:surgery / Q000662:veterinary*; D005260:Female; D006734:Horse Diseases / Q000401:mortality* / Q000601:surgery*; D006736:Horses; D007583:Jejunum / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000662:veterinary; D011446:Prospective Studies; D016019:Survival Analysis; D013537:Sutures / Q000662:veterinary; D016896:Treatment Outcome