Laparoscopic Closure of the Nephrosplenic Space in Horses with Nephrosplenic Colonic Entrapment: Factors Associated with Survival and Colic Recurrence.

This research investigated the factors linked to survival and colic recurrence in horses with nephrosplenic entrapment (NSE), a type of abdominal condition. Among the findings, significant factors affecting short-term survival included a rise in packed cell volume (PCV), the presence of other abdominal lesions, and reduced colic episodes following laparoscopic closure of the nephrosplenic space.

Research Methodology

• The researchers conducted a historic cohort with a nested case control analysis, using medical records of client-owned horses treated for NSE from January 1, 2002, to June 1, 2014.
• Various data was gathered from these records, including signalment (attributes such as age, breed, gender), physical examination parameters, laboratory results, diagnostic findings, and treatments.
• Factors linked to short-term survival till discharge were analyzed using a statistical method known as multivariable logistic regression model, while time to death post-discharge was analyzed using a Cox proportional hazards model.

Results

• During the study period, 211 horses experienced 231 NSE events. Among them, 91% or 192 horses survived to discharge.
• Findings showed that an increase in PCV (calculated by subtracting PCV after treatment from PCV at admission) correlated with reduced odds of survival, with each increment associated with the odds ratio (OR) of 0.899.
• Horses having concurrent alimentary lesions (additional digestive tract issues) had significantly higher odds of nonsurvival in the short term, with an odds ratio of 8.47.
• Out of 156 horses discharged and followed up on, 97% (152 horses) lived for a year or longer. However, increasing age at the time of hospital admission was found to be significantly associated with death following discharge, with a hazard ratio of 1.078.
• Recurrence of NSE took place in 23% (49 out of 211) of studied horses.
• Colic episodes were found to be reduced in horses that underwent laparoscopic closure of the nephrosplenic space, as compared to those that did not have the closure procedure (P<0.001).

Conclusions

• The study identified the increase in PCV and the presence of concurrent abdominal lesions as significant factors related to increased odds of nonsurvival to discharge in horses with NSE.
• Furthermore, laparoscopic closure of the nephrosplenic space was found to decrease the instances of colic episodes, highlighting the efficacy of this procedure in managing NSE in horses.