Surgical technique to repair grade IV rectal tears in post-parturient mares.

This research presents a surgical technique aimed at repairing grade IV rectal tears in mares after childbirth, detailing the method applied and sharing the results and outcomes. The method involves prolapsing rectal tears through the anal sphincter followed by a two-layer repair using staples, which are then oversewn.

Methodology

The experimental approach used in the study involved the sedation and restraint of post-parturient mares placed in standing stocks. The steps followed include:

• Administration of caudal anesthesia and evacuation of feces from the rectum.
• Aseptic preparation of the perineal region.
• Placement of four stay sutures through the external anal sphincter followed by vertical transection at the 12 o’clock position.
• Caudal retraction of the tear using either Allis tissue forceps or stay sutures, resulting in accurate apposition of the tear margins.
• The application of steel staples below the tissue forceps, followed by sharp dissection of mucosal edges, leaving approximately 5mm edges which are apposed in a single layer using 2-0 poliglecaprone 25 stitches.
• Administration of systemic antibiotics and anti-inflammatory agents postoperatively.
• Performs abdominal lavage while the mare is standing (in 3 of the 6 cases treated).

Results & Conclusion

Of the six mares treated with this technique, four survived long term and were able to reproduce again. One mare, subjected to exploratory celiotomy after surgical repair, unfortunately fractured her pelvis during recovery and was euthanized. Another mare was euthanized after 72 hours due to severe and diffuse peritonitis, although her surgical repair was still intact.

• These results indicate the potential effectiveness and viability of the proposed surgical technique in repairing grade IV rectal tears in mares.
• Through the outlined procedure, rectal tears can be exteriorized by prolapse through the anal sphincter after sphincterotomy.
• The repair can be secured in two layers with staples, with the staples oversewn with a continuous suture.

The authors concluded that rectal tears occurring as a result of childbirth can potentially be repaired efficiently using this oversewn stapled primary closure technique.