Comparison of short- and long-term complications and survival following jejunojejunostomy, jejunoileostomy and jejunocaecostomy in 112 horses: 2005-2010.
Abstract: There is disagreement among surgeons over whether jejunoileostomy (JI) or jejunocaecostomy (JC) is the better method of anastomosis following proximal ileal resection. Objective: To compare short- and long-term complications and outcome in horses undergoing jejunojejunostomy (JJ), JI and JC and to test the hypotheses that a higher proportion of horses undergoing JI would have short-term complications and mortality compared with horses undergoing JC or JJ and that JC would be associated with a higher long-term mortality and occurrence of colic. Methods: Retrospective cross-sectional study. Methods: Medical records of horses undergoing celiotomy for a small intestinal obstruction and JJ, JI or JC from 2005 to 2010 were reviewed. Post operative complications were recorded. Short-term outcome was alive vs. dead at hospital discharge and was analysed using a Chi-squared test. Long-term follow-up was obtained and a Kaplan-Meier estimate of the survivor function was performed. Results: There were 112 horses included. A higher proportion of JI horses had a repeat celiotomy during hospitalisation compared with horses undergoing JC. The number of horses alive at hospital discharge was not different between groups: JJ 79% (95% confidence interval [CI] 68-90%), JI 78% (95% CI 61-96%), JC 83% (95% CI 71-96%). Among horses discharged with long-term follow-up, more horses had colic after JC compared with JJ or JI. Long-term post discharge survival based on the Kaplan-Meier survivor function was lower for horses undergoing JC than JJ or JI (P = 0.04). Conclusions: While there was no difference in short-term outcome between groups, more horses with JI underwent a repeat celiotomy during hospitalisation. Horses with a JC were more likely to have long-term complications with colic. Horses that were subjected to euthanasia because of colic within 12 months of hospital discharge either had a JC or repeat celiotomy. The results suggest that, when possible, a JI may be the preferred method of anastomosis based on more favourable survival and lower occurrence of colic long term.
© 2013 EVJ Ltd.
Publication Date: 2013-10-31 PubMed ID: 23855729DOI: 10.1111/evj.12143Google Scholar: Lookup
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- Journal Article
Summary
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The research paper studies the immediate and long-term complications, as well as survivability after performing three types of surgery – jejunojejunostomy, jejunoileostomy, jejunocaecostomy – on horses with intestinal obstruction. The analysis reveals that while immediate outcomes didn’t vary significantly between these surgeries, jejunoileostomy became a favorable method due to its higher long-term survival rates and fewer incidences of colic.
Research Methodology
- The study used historical data and a cross-sectional approach. The medical records of 112 horses that underwent jejunojejunostomy, jejunoileostomy, or jejunocaecostomy from 2005 to 2010 due to small intestinal obstruction were analyzed.
- The researchers recorded post-operative complications. For short-term outcomes of the surgeries, they compared survival rates at hospital discharge using a Chi-squared test.
- Long-term outcomes were gauged using a Kaplan-Meier survival estimate based on follow-up data.
Findings
- In the short-term, survival rates across the three groups didn’t show much difference, with survival rates at hospital discharge being nearly equal in all cases (79% for jejunojejunostomy, 78% for jejunoileostomy, and 83% for jejunocaecostomy).
- However, horses undergoing jejunoileostomy had a higher rate of subsequent surgical intervention (repeat celiotomy) during their hospital stay as compared to horses that underwent jejunocaecostomy.
- The study found that more horses had colic after a jejunocaecostomy when compared to jejunoileostomy or jejunojejunostomy.
- In terms of long-term survival post-discharge, horses that had undergone jejunocaecostomy had lower survival rates than those that had undergone jejunoileostomy or jejunojejunostomy.
Conclusion
- The paper suggests that jejunoileostomy could be the preferred surgery method for horses with small intestinal obstruction. This conclusion is based on its lower occurrence of colic in the long-term and more favorable survival rates.
- However, the researchers also note that horses with jejunoileostomy underwent higher instances of repeat surgery during hospitalization.
- Horses subjected to euthanasia due to colic within 12 months of discharge had either undergone jejunocaecostomy or had a repeat surgery.
Cite This Article
APA
Stewart S, Southwood LL, Aceto HW.
(2013).
Comparison of short- and long-term complications and survival following jejunojejunostomy, jejunoileostomy and jejunocaecostomy in 112 horses: 2005-2010.
Equine Vet J, 46(3), 333-338.
https://doi.org/10.1111/evj.12143 Publication
Researcher Affiliations
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, USA.
MeSH Terms
- Animals
- Cecostomy / adverse effects
- Cecostomy / veterinary
- Female
- Horse Diseases / etiology
- Horses / surgery
- Intestinal Obstruction / surgery
- Intestinal Obstruction / veterinary
- Jejunoileal Bypass / adverse effects
- Jejunoileal Bypass / veterinary
- Jejunostomy / adverse effects
- Jejunostomy / veterinary
- Male
- Postoperative Complications / veterinary
- Retrospective Studies
- Time Factors
- Treatment Outcome
Citations
This article has been cited 5 times.- Ciammaichella L, Foglia A, Del Magno S, Cola V, Zanardi S, Tinto D, Capitani O, Joechler M, Pisoni L. Retrospective evaluation of a hand-sewn side-to-side intestinal anastomosis technique in dogs and cats.. Open Vet J 2023 Mar;13(3):278-287.
- Veerasammy B, Gonzalez G, Báez-Ramos P, Schaaf CR, Stewart AS, Ludwig EK, McKinney-Aguirre C, Freund J, Robertson J, Gonzalez LM. Changes in equine intestinal stem/progenitor cell number at resection margins in cases of small intestinal strangulation.. Equine Vet J 2023 Jan 30;.
- Mahne AT, Janse van Rensburg D, Hewetson M. Ileal hypertrophy and associated true diverticulum as a cause of colic in a horse.. J S Afr Vet Assoc 2017 May 26;88(0):e1-e5.
- Immonen IA, Karikoski N, Mykkänen A, Niemelä T, Junnila J, Tulamo RM. Long-term follow-up on recovery, return to use and sporting activity: a retrospective study of 236 operated colic horses in Finland (2006-2012).. Acta Vet Scand 2017 Jan 5;59(1):5.
- Salem SE, Proudman CJ, Archer DC. Has intravenous lidocaine improved the outcome in horses following surgical management of small intestinal lesions in a UK hospital population?. BMC Vet Res 2016 Jul 27;12(1):157.
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