School of Veterinary Science - Equine, University of Liverpool, Neston, UK.
Department of Epidemiology and Population Health, University of Liverpool, Neston, UK.
Equine Vet J. 2019 Jul;51(4):435-439. doi: 10.1111/evj.13035. Epub 2018 Nov 22.
Despite the regularity with which castration is performed, the types of complications and current best practice are unknown.
The objective of this study was to perform a prospective audit of routine equine castrations performed in general practice to determine complication rates and factors associated with them.
Multicentre, prospective audit of castrations.
Data on castrations were collected on the day of surgery from 18 veterinary practices; 30-days post-operatively follow-up was obtained and complications recorded. Frequency of complications was reported, and multilevel, multivariable logistic regression models used to investigate factors associated with the most common complications of bleeding in the first 24 h, stiffness of gait and/or swelling and discharge and/or infection.
Data were collected on 495 castrations performed by 53 participating veterinary surgeons. Over two thirds of surgeries were performed outside, 21% were performed under standing sedation and 79% with the horse recumbent. Almost all (98 and 97%) patients received preoperative nonsteroidal anti-inflammatories (NSAIDs) and antimicrobials, respectively. One or more intraoperative complications were reported in 14.5% of procedures; most common were bleeding and excessive movement. Follow-up to 30 days was available for 392 equids. One or more complications were reported in 44 castrations (11.2%). Swelling was the most common, then infection and stiffness of gait. Serious complications were rare.
It is possible that there was bias towards submission of data for procedures where complications occurred. The low complication rates reduced the power to determine factors associated with complications. Minor complications may go unreported by owners and may be underrepresented.
Overall complications associated with castration are low and mortality rare. Findings from this study can be used as guidelines for practices to perform regular audit to determine if their negative outcomes are comparable or warrant further investigation.
尽管去势是一种常规操作，但去势的并发症类型和当前的最佳实践尚不清楚。
本研究旨在对普通兽医诊所进行的常规马属动物去势进行前瞻性审核，以确定并发症发生率及其相关因素。
多中心、前瞻性去势审核。
从 18 家兽医诊所收集手术当天的去势数据；术后 30 天进行随访，并记录并发症。报告并发症的频率，并使用多水平、多变量逻辑回归模型来调查与前 24 小时内出血、步态僵硬和/或肿胀和分泌物/感染等最常见并发症相关的因素。
共收集了 53 名兽医外科医生进行的 495 例去势手术的数据。超过三分之二的手术是在户外进行的，21%的手术是在站立镇静下进行的，79%的手术是在马躺下时进行的。几乎所有（98%和 97%）患者分别接受了术前非甾体抗炎药（NSAIDs）和抗菌药物。14.5%的手术中报告了 1 种或多种术中并发症；最常见的是出血和过度运动。392 匹马进行了 30 天的随访。44 例（11.2%）报告了 1 种或多种并发症。肿胀最常见，其次是感染和步态僵硬。严重并发症罕见。
可能存在仅提交发生并发症手术数据的偏倚。低并发症发生率降低了确定与并发症相关因素的能力。所有者可能不会报告轻微并发症，这些并发症可能报告不足。
总体而言，去势相关的并发症发生率较低，死亡率较低。本研究的结果可作为兽医诊所进行常规审核的指南，以确定其不良结果是否可比或是否需要进一步调查。
