Baxter G M, Broome T E, Moore J N
Department of Large Animal Medicine, University of Georgia, Athens 30602.
Vet Surg. 1989 Nov-Dec;18(6):409-14. doi: 10.1111/j.1532-950x.1990.tb01115.x.
One hundred thirteen of 172 horses (66%) undergoing exploratory celiotomy for a small intestinal lesion survived 4 or more days after surgery. Intra-abdominal adhesions causing clinical problems requiring additional surgery or euthanasia were documented in 25 horses (22.1%). Problems developed in significantly more males than females. The most common initial small bowel lesion was ileal impaction (12 horses); 21 horses underwent small intestinal resection or bypass. However, there was no significant difference in the incidence of intra-abdominal adhesions between horses that underwent intestinal resection or bypass and those that did not. Only 4 of the 25 horses (16%) with problems associated with postoperative adhesions survived. The mean interval between surgical procedures or between the initial procedure and euthanasia for all horses was 84 days (range, 7-512 days; median, 25 days). However, 70% of the subsequent celiotomies were performed within 60 days of the previous surgery. The mean interval between celiotomies was 221 days (range, 9-512 days) for the survivors and 61 days (range, 7-358 days) for the nonsurvivors. These results indicated that most of the problems related to postoperative intra-abdominal adhesions occurred within 2 months of the initial small intestinal surgery. Furthermore, the earlier development of postoperative adhesions was associated with a poorer prognosis for survival.
172匹因小肠病变接受剖腹探查术的马中，113匹（66%）术后存活4天或更长时间。25匹马（22.1%）出现腹腔粘连并引发临床问题，需要再次手术或实施安乐死。出现问题的雄性马显著多于雌性马。最常见的初始小肠病变是回肠阻塞（12匹马）；21匹马接受了小肠切除或旁路手术。然而，接受小肠切除或旁路手术的马与未接受此类手术的马相比，腹腔粘连的发生率并无显著差异。在25匹出现术后粘连相关问题的马中，只有4匹（16%）存活。所有马再次手术之间或首次手术与安乐死之间的平均间隔时间为84天（范围7 - 512天；中位数25天）。然而，70%的后续剖腹探查术是在上次手术后60天内进行的。存活马两次剖腹探查术之间的平均间隔时间为221天（范围9 - 512天），非存活马为61天（范围7 - 358天）。这些结果表明，大多数与术后腹腔粘连相关的问题发生在初次小肠手术后的2个月内。此外，术后粘连出现得越早，存活预后越差。
