Freeman David E, Schaeffer David J
Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802, USA.
J Am Vet Med Assoc. 2010 Nov 1;237(9):1060-7. doi: 10.2460/javma.237.9.1060.
To evaluate survival rate and complications after jejunocecostomy in horses with colic and to compare outcomes after hand-sewn versus stapled side-to-side jejunocecostomy.
Retrospective cohort study.
32 horses.
Information was retrieved from medical records and through telephone calls on horses that had a hand-sewn or stapled side-to-side jejunocecostomy for treatment of colic, which was performed by or under the supervision of the same surgeon. Kaplan-Meier life table analysis was used to compare survival times and rates between horses that underwent a hand-sewn or stapled side-to-side anastomosis.
32 horses met inclusion criteria; 22 underwent a hand-sewn anastomosis, and 10 underwent a stapled anastomosis. Horses in the stapled group had a significantly greater prevalence of postoperative colic and combined postoperative colic and reflux than horses in the hand-sewn group. In the hand-sewn group, repeated celiotomy was performed within the same hospitalization period for 3 of 22 horses; in the stapled group, 4 of 10 horses had repeated celiotomies. Hospital discharge rates (ie, short-term survival rates) were similar between horses in the hand-sewn group (20/22 horses) and those in the stapled group (9/10 horses). Long-term survival rates were similar for both groups, ranging from 5 to 126 months.
Short- and long-term results justify use of jejunocecostomy in horses. Despite similar survival rates between groups, horses that underwent a stapled anastomosis had significantly greater prevalences of postoperative complications than horses that underwent a hand-sewn anastomosis, suggesting that horses were sensitive to minor differences in anastomosis techniques.
评估患急腹症马行空肠回肠吻合术后的存活率及并发症,并比较手工缝合与吻合器侧侧空肠回肠吻合术后的效果。
回顾性队列研究。
32匹马。
从病历中获取信息,并通过电话联系那些接受了由同一位外科医生或在其监督下进行的手工缝合或吻合器侧侧空肠回肠吻合术以治疗急腹症的马匹。采用Kaplan-Meier生存表分析来比较接受手工缝合或吻合器侧侧吻合术的马匹的生存时间和存活率。
32匹马符合纳入标准;22例行手工缝合吻合术,10例行吻合器吻合术。吻合器组马术后急腹症以及术后急腹症合并反流的发生率显著高于手工缝合组。在手工缝合组,22匹马中有3匹在同一住院期间再次进行了剖腹术;在吻合器组,10匹马中有4匹再次进行了剖腹术。手工缝合组马(20/22匹马)和吻合器组马(9/10匹马)的出院率(即短期存活率)相似。两组的长期存活率相似,范围为5至126个月。
空肠回肠吻合术应用于马的短期和长期效果是合理的。尽管两组存活率相似,但接受吻合器吻合术的马术后并发症的发生率显著高于接受手工缝合吻合术的马,这表明马对吻合技术的微小差异敏感。