Indications, complications, and outcome of horses undergoing repeated celiotomy within 14 days after the first colic surgery: 95 cases (2005–2013)

Abstract

EQUINE Indications, complications, and prognosis for horses undergoing exploratory colic surgery for a variety of conditions have been extensively described. [1][2][3][4][5][6][7][8][9] Although the quality of care and rate of survival to hospital discharge for horses undergoing colic surgery have increased over the past decades and are now generally considered good, several complications can occur during the immediate postoperative period, which influence short-and long-term outcome. 5,10Postoperative ileus and recurring colic are considered the most commonly encountered problems and, if severe or unrelenting, might require a second celiotomy shortly after the first procedure. Little information is available about horses requiring a second abdominal surgery shortly after

Factors associated with survival of horses following relaparotomy

“…Short-term outcomes of horses undergoing relaparotomy in the present study were similar to earlier studies that reported overall short-term survival of 40-49% and 51-62% survival for those that recovered from general anaesthesia following relaparotomy [1,3,6]. This finding is consistent with that of Mair and Smith [1] but in contrast to Dunkel et al where persistent POR was the predominant reason for relaparotomy [7]. In man, relaparotomy is performed in 0.5-22% of patients following laparotomy and mortality rates range from 22 to 71%, with abdominal sepsis being associated with highest rates of mortality [17][18][19] horses undergoing relaparotomy (relaparotomy whole cohort), the 67 horses that were recovered from anaesthesia following relaparotomy (survived surgery group) and the 43 horses that were discharged from the hospital following relaparotomy (discharged home group).…”

“…Despite different inclusion criteria regarding timing of relaparotomy in relation to initial laparotomy, time between surgical procedures was similar to the findings of Mair and Smith [1] and Dunkel et al [7]. Despite different inclusion criteria regarding timing of relaparotomy in relation to initial laparotomy, time between surgical procedures was similar to the findings of Mair and Smith [1] and Dunkel et al [7].…”

“…Evidence-based information can assist decision-making about management of horses that have developed complications following laparotomy, based on factors such as likely survival of horses following relaparotomy and costs of treatment. Reported rates of intraoperative death or euthanasia during relaparotomy are 21-25% [1,3,7] and for all horses undergoing relaparotomy, short-term survival (survival to hospital discharge) is reported to be 40-45% [1,7]. Reported rates of intraoperative death or euthanasia during relaparotomy are 21-25% [1,3,7] and for all horses undergoing relaparotomy, short-term survival (survival to hospital discharge) is reported to be 40-45% [1,7].…”

Post‐operative reflux – a surgeon's perspective

“…A repeat celiotomy only resolved POR in 25% of horses with this complication in one study (Dunkel et al . ) and POR was recorded in 62% of horses after repeat celiotomy in another (Mair and Smith ). This is contrary to the author's experience with repeat celiotomy (Easley et al .…”

“…Although an early repeat celiotomy is a recognised treatment for POR (Dunkel et al . ), it could also increase the risk for this by compounding existing mural inflammation and thereby inhibiting intestinal motility (Boeckxstaens and de Jonge ). A repeat celiotomy only resolved POR in 25% of horses with this complication in one study (Dunkel et al .…”