Surgical treatment of epiploic foramen entrapment in 142 horses (2008-2016).
Abstract: To report the clinical features, outcomes, and prognostic factors associated with the surgical treatment of epiploic foramen entrapment (EFE). Methods: Retrospective study at a single referral hospital. Methods: Horses (n = 142) undergoing surgery (n = 145) for EFE. Methods: Preoperative, perioperative, and postoperative data of surgeries on horses that underwent exploratory laparotomy for EFE were obtained. The postoperative outcome was assessed by follow-up telephone calls with the owners/caregivers. Factors associated with postoperative reflux (POR), relaparotomy, hospital discharge, colic after hospital discharge, and survival after discharge were assessed. Results: In total, 145 surgeries were performed on 142 horses (recurrence rate, 3%). Warmblood horses represented 85% of the horses that underwent surgery. Windsucking/crib-biting was confirmed in 60% of these surgery cases. Left-to-right entrapment was diagnosed in all horses. Ileal involvement was recorded in 74% of the cases. Uncontrollable intraoperative hemorrhage was encountered in 6% of the surgeries. One hundred seven (74%) horses recovered from surgery, and 65% of those survived to discharge. The rate of survival to discharge of all surgeries was 48%. The median survival of the cases that were discharged exceeded 3193 days. Horses requiring intestinal resection were predisposed to POR, and those undergoing jejunoileostomy were more prone to POR than those undergoing jejunojejunostomy. Horses with POR were less likely to be discharged than those without POR, and those that underwent resection had shorter life expectancy after hospital discharge than those that did not undergo resection. Conclusions: Surgical treatment of EFE was associated with high morbidity and mortality, with recurrence in at least 3% of surviving horses. Conclusions: Owners of horses with EFE should be informed of the guarded prognosis associated with current surgical treatment.
© 2019 The American College of Veterinary Surgeons.
Publication Date: 2019-01-21 PubMed ID: 30666674DOI: 10.1111/vsu.13161Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
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The research paper analyzes the clinical features, outcomes and prognostic factors pertaining to the surgical treatment of Epiploic Foramen Entrapment (EFE), a condition affecting horses. It observes the correlation between the treatment and factors such as postoperative reflux, relaparotomy, survival after hospital discharge, amongst others.
Objective and Methodology
- The study is a retrospective one, conducted at a single referral hospital, targeting the surgical treatment of Epiploic Foramen Entrapment (EFE) on 142 horses.
- For the purposes of the study, preoperative, perioperative, and postoperative data were gathered for horses that underwent exploratory laparotomy.
- The researchers determined the postoperative outcome by executing follow-up telephone calls with the owners/caregivers of the horses.
Results
- The study found that 145 surgeries were performed on 142 horses, indicating a recurrence rate of 3%.
- 85% of the horses involved in the surgeries were Warmblood horses and 60% of the surgical cases confirmed Windsucking and/or crib-biting behavior.
- All the horses diagnosed showed a left-to-right entrapment and ileal involvement was recorded in 74% of cases.
- The surgery encountered cases of uncontrollable intraoperative hemorrhage in 6% of surgeries.
- Approximately 74% of horses recovered from surgery and 65% of those later survived to be discharged. The overall survival rate of surgeries was 48%, while the median survival rate of discharged cases exceeded 3193 days.
Prognostic associations
- The study noted that horses requiring an intestinal resection were prone to postoperative reflux (POR). Furthermore, those undergoing jejunoileostomy were more likely to encounter POR than those undergoing jejunojejunostomy.
- It was also found that horses with POR were less likely to be discharged than those without POR and that horses undergoing resection had a shorter life expectancy after hospital discharge compared to those who did not.
Conclusions
- EFE surgeries reported cases of high morbidity and mortality.
- The research emphasizes that owners of horses with EFE must be apprised of the associated guarded prognosis of existing surgical treatment.
Cite This Article
APA
van Bergen T, Haspeslagh M, Wiemer P, Swagemakers M, van Loon G, Martens A.
(2019).
Surgical treatment of epiploic foramen entrapment in 142 horses (2008-2016).
Vet Surg, 48(3), 291-298.
https://doi.org/10.1111/vsu.13161 Publication
Researcher Affiliations
- Department of Surgery and Anesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
- Clinique Equine d'Acy-Romance, Acy-Romance, France.
- Department of Surgery and Anesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
- Department of Surgery and Anesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
- De Lingehoeve Diergeneeskunde, Lienden, The Netherlands.
- Department of Surgery and Anesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
- Department of Surgery and Anesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
MeSH Terms
- Animals
- Colic / surgery
- Colic / veterinary
- Digestive System Surgical Procedures / methods
- Digestive System Surgical Procedures / veterinary
- Female
- Gastroesophageal Reflux / surgery
- Horse Diseases / surgery
- Horses
- Intestinal Obstruction / surgery
- Intestinal Obstruction / veterinary
- Intestine, Small / surgery
- Laparotomy / veterinary
- Male
- Postoperative Complications / veterinary
- Postoperative Period
- Retrospective Studies
Grant Funding
- Department of Surgery and Anesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University
Citations
This article has been cited 3 times.- Asin J, Nyaoke AC, Samol MA, Arthur RM, Uzal FA. Clostridioides (Clostridium) difficile-associated disease, epiploic foramen entrapment, and gastric rupture in a Thoroughbred racehorse: case report and literature review.. J Vet Diagn Invest 2022 Sep;34(5):913-917.
- Erwin SJ, Clark ME, Dechant JE, Aitken MR, Hassel DM, Blikslager AT, Ziegler AL. Multi-Institutional Retrospective Case-Control Study Evaluating Clinical Outcomes of Foals with Small Intestinal Strangulating Obstruction: 2000-2020.. Animals (Basel) 2022 May 27;12(11).
- Bishop RC, Gutierrez-Nibeyro SD, Stewart MC, McCoy AM. Performance of predictive models of survival in horses undergoing emergency exploratory laparotomy for colic.. Vet Surg 2022 Aug;51(6):891-902.