Survival and Complications After Large Colon Resection and End-to-End Anastomosis for Strangulating Large Colon Volvulus in Seventy-Three Horses

• Published in: Veterinary surgery Vol. 37; no. 8; pp. 786 - 790
• Main Authors: ELLIS, CHRISTINA M, LYNCH, TIMOTHY M, SLONE, DONNIE E, HUGHES, FAITH E, CLARK, CAROL K
• Format: Journal Article
• Language: English
• Published: Malden, USA Malden, USA : Blackwell Publishing Inc 01.12.2008; Blackwell Publishing Inc; Blackwell Publishing Ltd
• Subjects: acute course; anastomosis; Anastomosis, Surgical - methods; Anastomosis, Surgical - veterinary; Animals; colic; Colic - epidemiology; Colic - veterinary; Colon; Colonic Diseases - mortality; Colonic Diseases - surgery; Colonic Diseases - veterinary; diarrhea; Diarrhea - epidemiology; Diarrhea - veterinary; Female; horse diseases; Horse Diseases - surgery; Horses; Intestinal Volvulus - mortality; Intestinal Volvulus - surgery; Intestinal Volvulus - veterinary; Male; Medical prognosis; methodology; morbidity; mortality; Multivariate Analysis; postoperative complications; Postoperative Complications - epidemiology; Postoperative Complications - veterinary; Prognosis; Proportional Hazards Models; resection; Retrospective Studies; risk assessment; Side effects; Surgery; Survival Analysis; Treatment Outcome; Veterinary services; volvulus
• ISSN: 0161-3499; 1532-950X
• DOI: 10.1111/j.1532-950X.2008.00449.x

To report complications and survival after large colon resection and end-to-end anastomosis in horses with strangulating large colon volvulus. Retrospective case series. Horses (n=73) with strangulating large colon volvulus. Records (January 1995 to December 2005) of horses that had large colon resection and anastomosis for strangulating large colon volvulus were reviewed for complications. Follow-up data were obtained by telephone questionnaire at least 1 year postoperatively. Cox proportional hazards model was used for multivariate association with survival time. Variables included admission date, age, temperature, heart rate, packed cell volume, total plasma protein concentration, white blood cell count, breed, and sex. Significance was set at P<.05. The most common postoperative complication was diarrhea. None of the 9 variables of interest were significant for survival. Short-term survival rate (to discharge) was 74%. Overall survival rates at 1, 2, and 3 years postoperatively were 67.8%, 66.0%, and 63.5%, respectively. Four horses died of colic in the first year after surgery. All horses surviving long-term (>1 year) returned to their intended use (37 brood mares, 2 racehorses, and 1 show horse) with no chronic problems related to the surgical procedure. None of the variables examined were associated with survival. Outcomes were similar to other large studies of surgical colic in the horse. Self-limiting diarrhea is common after large colon resection and the prognosis for survival after hospital discharge is favorable. Horses that survive the early postoperative period and are discharged after large colon resection and anastomosis have a good chance for long-term survival with minimal negative impact on quality of life and use.