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Veterinary surgery : VS2019; 48(7); 1204-1210; doi: 10.1111/vsu.13306

Use of perioperative variables to determine the requirement for repeat celiotomy in horses with postoperative reflux after small intestinal surgery.

Abstract: To determine whether perioperative variables can be used to differentiate a medical vs a surgical reason for postoperative reflux (POR) after small intestinal (SI) surgery in horses. Methods: Retrospective study. Methods: Horses >1 year of age that recovered from SI surgery and had POR. Methods: Medical records of horses that underwent SI surgery and developed POR from 2009-2015 were reviewed. Surgical reasons for POR were defined as an anastomosis complication, mechanical obstruction, or nonviable intestine identified at repeat celiotomy/necropsy. A medical reason for POR was presumed when the POR improved with medical treatment or when no surgical reasons were identified at repeat celiotomy/necropsy. Perioperative variables were analyzed and used to develop a logistic regression model. Results: Fifty-one horses had POR after SI surgery. After initial SI surgery, 14 horses had surgical reasons for POR diagnosed at repeat celiotomy or necropsy. Thirty-seven horses were considered to have medical reasons for POR because their POR resolved with medical management or functional ileus was diagnosed at repeat celiotomy/necropsy. A greater volume and a greater duration of POR were not associated with a surgical reason for POR. Rather, a postoperative (PO) fever and the timing of colic in the PO period were associated with a surgical reason for POR. Conclusions: Horses that developed a fever and colic in the PO period after SI surgery were more likely to have a surgical reason for POR. Conclusions: These findings may provide guidance for clinicians when they are making decisions about repeat celiotomy in horses with POR after SI surgery.
© 2019 The American College of Veterinary Surgeons.
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Publication Date: 2019-08-12 PubMed ID: 31403222DOI: 10.1111/vsu.13306Google Scholar: Lookup
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  • Journal Article

Summary

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This research investigates whether certain perioperative variables can predict if postoperative reflux (POR) following small intestinal surgery in horses is due to a medical or surgical cause. The study concludes that horses that develop a fever and colic in the postoperative period are more likely to have a surgical reason for POR.

Methods

  • The research is a retrospective study, studying past events, on horses one year old and above that had recovered from small intestinal (SI) surgery and had developed postoperative reflux (POR).
  • The medical records of these horses that underwent SI surgery and developed POR from 2009-2015 were thoroughly reviewed.
  • Surgical reasons for POR were identified through repeat celiotomy or necropsy and were characterized by complications in the surgical connection (anastomosis), mechanical obstruction, or nonviable sections of the intestine.
  • Medical reasons for POR, on the other hand, were presumed when the POR improved through medical treatments or when no surgical reasons were identified upon repeat celiotomy or necropsy.
  • These perioperative variables were then analyzed and factored into a logistic regression model to examine patterns and potential predictive factors.

Results

  • Fifty-one horses developed POR after their SI surgery.
  • Of these fifty-one, fourteen horses displayed surgical causes for POR as diagnosed through repeat celiotomy or at necropsy.
  • The remaining thirty-seven horses are supposed to have had medical causes of POR, as their condition improved through medical treatment or a functional ileus was diagnosed at repeat celiotomy/necropsy.
  • Contrary to expectations, an increased volume or duration of POR did not correlate with a surgical reason for POR.
  • Interestingly, a postoperative fever and the timing of colic in the postoperative period were factors associated with a surgical reason for POR.

Conclusions

  • The study concludes that horses that develop a fever and colic after SI surgery were more likely to have a surgical reason for POR.
  • The findings could provide crucial guidance for clinicians when making decisions on whether to perform repeat celiotomy on horses with POR after SI surgery.

Cite This Article

APA
Jacobs CC, Stefanovski D, Southwood LL. (2019). Use of perioperative variables to determine the requirement for repeat celiotomy in horses with postoperative reflux after small intestinal surgery. Vet Surg, 48(7), 1204-1210. https://doi.org/10.1111/vsu.13306

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 48
Issue: 7
Pages: 1204-1210

Researcher Affiliations

Jacobs, Carrie C
  • Department of Large Animal Clinical Sciences, Large Animal Clinical Sciences, Michigan State University, East Lansing, Michigan.
Stefanovski, Darko
  • Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania.
Southwood, Louise L
  • Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania.

MeSH Terms

  • Anastomosis, Surgical / veterinary
  • Animals
  • Colic / surgery
  • Colic / veterinary
  • Digestive System Surgical Procedures / veterinary
  • Female
  • Gastroesophageal Reflux / veterinary
  • Horse Diseases / surgery
  • Horses
  • Humans
  • Intestinal Obstruction / surgery
  • Laparotomy / veterinary
  • Logistic Models
  • Male
  • Postoperative Complications / veterinary
  • Postoperative Period
  • Reoperation / veterinary
  • Retrospective Studies

References

This article includes 21 references
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Citations

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