Laparoscopic Closure of the Nephrosplenic Space in Horses with Nephrosplenic Colonic Entrapment: Factors Associated with Survival and Colic Recurrence

Nelson, Brad B.; Ruple-Czerniak, Audrey; Hendrickson, Dean A.; Hackett, Eileen S.

doi:10.1111/vsu.12549

Cited by 24 publications

(33 citation statements)

References 27 publications

(138 reference statements)

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“…Recognition of the risk for colonic displacements to recur, such as RDDC and NSE , has led to surgical prevention by colopexy or colon resection . Although laparoscopy is beyond the scope of this review, many laparoscopic methods have been developed to prevent recurrent colic, such as nephrosplenic space ablation , vaginal ring closure , and closure of the epiploic foramen by a mesh implant or titanium helical coils . Insertion of a specially constructed mesh at time of open correction of EFE represents a simple method of preventing recurrence of this disease .…”

Section: Survival Rates In Last 50 Yearsmentioning

confidence: 99%

“…For example, survival rates are higher after surgery for large versus small intestinal obstructions in adult horses and foals and the number of large intestinal lesions can be double that of small intestinal lesions in hospital‐based studies . Nonstrangulating obstructions account for a larger proportion of all diseases in the large intestine than they do in the small intestine and can have short‐term survival rates ≥88% . Both NSE and RDDC were not described in the English literature before 1977 , but their prominence in recent studies and favourable outcomes associated with them could explain improved overall survival from colic surgery over the last half century .…”

Section: Survival According To Segment Affectedmentioning

confidence: 99%

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Fifty years of colic surgery

Freeman

2018

Equine Veterinary Journal

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Colic surgery is one of few treatments in which a veterinarian can use a skill to save an animal's life from a deadly disease within a short timeframe. Unfortunately, such success is not achieved without considerable risk for surgical failure, which is responsible for most complications in the immediate post-operative period. The last 50 years have witnessed considerable improvements in colic surgery, although a ranking of the most important ones might not meet with universal agreement. Teamwork plays a critical role in the final outcome, starting and finishing with the referring veterinarian and owner. These individuals are responsible for promptly transferring the horse to a surgical facility and then dealing with aftercare and delayed complications. The surgeon is responsible for the intervening steps, including the decision on the need for surgery, and works with the anaesthesiologist to help a metabolically challenged patient to tolerate surgery and anaesthesia. Although early referral and improved diagnostic procedures can have a positive influence on survival, perceived improvements in surgery and anaesthesia need to be reviewed with some circumspection. Although more rigorous definitions and statistical analyses used in recent studies can invalidate comparisons with older studies, complication rates appear to be on the rise, despite putative improvements in dealing with them. This trend tends to diminish the value of colic surgery through increasing costs, overreliance on post-operative pharmacological management, growing pessimism, high rates of intraoperative euthanasia, and possibly reduced long-term survival. Future efforts should address these concerns, mostly through emphasis on prompt referral, good surgical technique and reducing the cost of colic surgery to an affordable level that saves more lives.

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Section: Survival Rates In Last 50 Yearsmentioning

confidence: 99%

Section: Survival According To Segment Affectedmentioning

confidence: 99%

Fifty years of colic surgery

Freeman

2018

Equine Veterinary Journal

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“…The objectives of this study by Brad Nelson and colleagues in the USA were to identify factors associated with short‐term survival and time to death after hospital discharge in horses with nephrosplenic entrapment (NSE) and to compare the frequency of recurrent colic episodes in horses with and without laparoscopic closure of the nephrosplenic space .…”

Section: Nephrosplenic Colonic Entrapmentmentioning

confidence: 99%

Highlights of recent clinically relevant papers

Wright¹

2017

Equine Veterinary Education

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“…Left dorsal displacement of the large colon (LDDLC), or nephrosplenic entrapment, occurs when the ascending (left) colon displaces dorsally in the nephrosplenic space, over its ligament [1] [2] [3], with a reported incidence ranging from 6% to 9% of colic cases [2] [3] [4]. A reported recurrence rate ranging from 3.2% to 23% [1] [3] [4] [5], with an individual incidence up to 5 times [4], advocates preventive closure of the nephrosplenic space, which has been shown to prevent LDDLC recurrence and significantly decrease colic scores in the long term [3] [6]. The procedure can be performed through under general anesthesia or standing through a flank incision with resection of the last rib [5] [7].…”

Section: Introductionmentioning

confidence: 99%

Closure of the Equine Nephrosplenic Space Using a Single LED Powered Trocar via Standing Mini-Laparotomy

Bussy¹,

Benredouane²,

Muñoz³

et al. 2019

OJVM

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Objective: To evaluate a technique using a custom-developed LED powered Single Port Trocar for closure of the nephrosplenic space via a standing mini-laparotomy. Design: Prospective case series. Animals: 60 client-owned horses with a history of nephrosplenic entrapment. Procedures: The nephrosplenic space was closed under direct visualization through a specifically designed LED powered Single Port Trocar in standing sedated horses having experienced recurrence or previous surgical correction of a nephrosplenic entrapment. Obliteration of the space was performed in a cranial to caudal direction in a simple continuous fashion. Time required for suturing the nephrosplenic space, as well as per and post-operative complications were recorded. Clients and referring veterinarians were asked to communicate any complication that occurred after discharge. Results: Surgical time ranged from 23 to 45 min. No complication except for self-limited spleen capsule bleeding occurred during the procedure. Minor wound discharge was noted in 2 cases, and another 2 horses developed post-surgical sweating patches close to the incision. All horses were allowed to progressively resume exercise, starting 1 month post discharge from the hospital. Cosmetic results were considered satisfactory and no recurrence of left dorsal displacement of the colon was reported post-surgery. Conclusions and clinical relevance: A Single Port LED powered Trocar is a technique that allows effective, fast, and safe closure of the nephrosplenic space in the standing horse with minimal instrumentation.

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Laparoscopic Closure of the Nephrosplenic Space in Horses with Nephrosplenic Colonic Entrapment: Factors Associated with Survival and Colic Recurrence

Abstract: An increase in PCV from admission to after treatment and concurrent abdominal lesions were associated with increased odds of nonsurvival to discharge in horses with NSE. Horses that underwent laparoscopic closure had reduced colic episodes compared with horses without laparoscopic closure.

Cited by 24 publications

References 27 publications

Fifty years of colic surgery

Fifty years of colic surgery

Highlights of recent clinically relevant papers

Closure of the Equine Nephrosplenic Space Using a Single LED Powered Trocar via Standing Mini-Laparotomy

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