Response to early repeat celiotomy in horses after a surgical treatment of jejunal strangulation.

This research explored the effectiveness of repeat surgery (celiotomy) in horses following a previous surgical treatment for a condition called jejunal strangulation. The results showed that a second surgery was useful for managing post operation complications, and it did not increase the challenges of recovery.

Methodology

The research was designed as a retrospective case series. It reviewed 22 cases of horses that underwent repeat celiotomy due to either postoperative reflux (POR) or postoperative colic (POC) which did not improve within two days after the initial surgical treatment. The initial surgeries they underwent were either jejunojejunostomy (14 cases) or no resection (8 cases). Medical records were thoroughly investigated for clinical signs, duration of signs before the repeat surgery, and the results of the surgeries. Long-term survival was also documented through phone call follow-ups. Statistical processes like Kaplan-Meier analyses were used to assess long term survival.

Results

• The repeat surgery was usually conducted about 57 hours after the initial surgical operation. For horses that reported signs of complications, this was done 16.5 hours from the onset of the signs.
• Earlier surgery was done for horses with postoperative colic compared to those with postoperative reflux.
• About three horses were euthanized under anesthesia.
• For 9 out of 11 horses that underwent the initial jejunojejunostomy, resection of the original anastomosis was required due to complications.
• Those that did not undergo resection during the first surgery, the second surgery involved either resection (4 horses) or decompression (4 horses).
• 13 out of 16 horses with postoperative reflux were successfully treated with repeat celiotomy.
• All 9 horses with postoperative colic saw the elimination of the colic symptoms after the repeat celiotomy.
• Of the 19 horses that recovered from anesthesia, all of them survived until discharge.
• Incisional infections were found in 13 out of 17 cases where both surgeries were performed through the same ventral median approach. Four of the infected incisions developed hernias.
• Median survival time post-surgery was 90 months.

Conclusions

The study concluded that repeating celiotomy could effectively eliminate signs of postoperative colic and reflux. Additionally, the follow-up surgery did not seem to increase the likelihood of postoperative reflux. The criteria used in the study for repeat celiotomy could offer insights and guidelines for managing postoperative reflux and postoperative colic after surgical treatment of jejunal strangulation.