Spoormakers T J P, Graat E A M, ter Braake F, Stout T A E, Bergman H J
Lingehoeve Diergeneeskunde, Lienden, The Netherlands.
Quantitative Veterinary Epidemiology Group, Wageningen Institute of Animal Sciences (WIAS), Wageningen University, Wageningen, The Netherlands.
Equine Vet J. 2016 Mar;48(2):172-5. doi: 10.1111/evj.12418. Epub 2015 Mar 4.
Previous surveys have reported that mare and foal survival after correction of uterine torsion (UT) varies from 60 to 84% and from 30 to 54%, respectively. Furthermore, resolution via a standing flank laparotomy (SFL) has been associated with better foal, but not mare, survival.
To compare the success of SFL with other correction methods (e.g. midline or flank laparotomy under general anaesthesia; correction per vaginam).
Retrospective analysis of clinical records.
Data on correction technique, stage of gestation, degree of rotation, survival and subsequent fertility for 189 mares treated for UT at 3 equine referral hospitals in The Netherlands during 1987-2007 were analysed.
Mean stage of gestation at diagnosis was 283 days (range 153-369 days), with the majority of UTs (77.5%) occurring before Day 320 of gestation. After correction of UT, 90.5% of mares and 82.3% of foals survived to hospital discharge, between 3 and 39 days later, and to foaling. Multivariable logistic regression indicated that correction method and stage of gestation at UT affected survival of foals and mares. For foals, survival was 88.7% after SFL compared with 35.0% after other methods (P = 0.001). When UT occurred at <320 days, 90.6% of foals survived, compared with 56.1% at ≥320 days (P = 0.007). For mare survival, an interaction between stage of gestation and correction method was detected (P = 0.02), with higher survival after SFL (97.1%) than other methods (50.0%) at <320 days of gestation (P<0.01). When UT occurred at ≥320 days, mare survival did not differ between techniques (76.0 vs. 68.8%; P = 0.6). Of 123 mares that were bred again, 93.5% became pregnant; fertility did not differ between mares treated by SFL (93.9%) and other techniques (87.5%; P = 0.9).
Standing flank laparotomy is the surgical technique of choice for resolving uncomplicated equine UT (i.e. with no coexisting gastrointestinal lesions) except when the stage of gestation exceeds 320 days.
以往的调查显示，子宫扭转（UT）矫正术后母马和马驹的存活率分别为60%至84%和30%至54%。此外，通过站立侧腹剖腹术（SFL）进行矫正与马驹存活率提高相关，但与母马存活率无关。
比较SFL与其他矫正方法（如全身麻醉下的中线或侧腹剖腹术；经阴道矫正）的成功率。
对临床记录进行回顾性分析。
分析了1987年至2007年期间在荷兰3家马转诊医院接受UT治疗的189匹母马的矫正技术、妊娠阶段、扭转程度、存活率及后续生育能力的数据。
诊断时的平均妊娠阶段为283天（范围153 - 369天），大多数UT（77.5%）发生在妊娠第320天之前。UT矫正后，90.5%的母马和82.3%的马驹存活至出院，出院时间在3至39天后，且存活至分娩。多变量逻辑回归表明，矫正方法和UT时的妊娠阶段影响马驹和母马的存活率。对于马驹，SFL后存活率为88.7%，而其他方法后为35.0%（P = 0.001）。当UT发生在<320天时，90.6%的马驹存活，而≥320天时为56.1%（P = 0.007）。对于母马存活率，检测到妊娠阶段和矫正方法之间存在交互作用（P = 0.02），在妊娠<320天时，SFL后的存活率（97.1%）高于其他方法（50.0%）（P<0.01）。当UT发生在≥320天时，不同技术之间母马存活率无差异（76.0%对68.8%；P = 0.6）。在123匹再次配种的母马中，93.5%怀孕；SFL治疗的母马（93.9%）和其他技术治疗的母马（87.5%）的生育能力无差异（P = 0.9）。
站立侧腹剖腹术是解决单纯性马UT（即无并存胃肠道病变）的首选手术技术，除非妊娠阶段超过320天。
