Gardner Alison, Dockery Allison, Quam Vivian
The Ohio State University, Columbus, Ohio.
The Ohio State University, Columbus, Ohio.
Top Companion Anim Med. 2019 Mar;34:1-9. doi: 10.1053/j.tcam.2018.11.001. Epub 2018 Nov 16.
To review indications and risk factors for exploratory celiotomy secondary to acute colic in the horse; decision making for and during surgery; and prognosis for return to function after exploratory celiotomy for the practicing veterinarian. Data sources included scientific reviews and original research publications from veterinary sources, as well as clinical data specifically in regard to underlying disease and survival rates from a tertiary referral hospital where exploratory celiotomy is commonly performed. There is a high positive predictive value of specific clinical preoperative parameters of the equine acute abdomen, many of which rely on techniques available to field practitioners, relative to the need for surgical intervention. Decision making regarding surgical procedure or even intraoperative euthanasia depends on owner expectations. Survival rates following exploratory celiotomy range from fair to excellent (60%-100%) depending on underlying lesion and return to athleticism following celiotomy is good to excellent (76%-90%). A knowledge base of indications for and rates of survival from colic requiring exploratory celiotomy in the horse is of paramount importance to the equine practitioner. Preconceived notions of poor survival rates are rampant among horse owners, and owners rely on their primary veterinarian's advice for continuation to referral center and in further treatment including exploratory celiotomy.
回顾马急性腹痛继发探查性剖腹术的适应症和危险因素;手术决策及术中决策;以及为执业兽医提供探查性剖腹术后恢复功能的预后情况。数据来源包括兽医领域的科学综述和原始研究出版物,以及来自一家经常进行探查性剖腹术的三级转诊医院的关于基础疾病和存活率的临床数据。相对于手术干预的需求,马急性腹部的特定术前临床参数具有较高的阳性预测价值,其中许多参数依赖于现场从业者可用的技术。关于手术程序甚至术中安乐死的决策取决于主人的期望。探查性剖腹术后的存活率从一般到极佳(60%-100%)不等,具体取决于潜在病变,剖腹术后恢复运动能力的情况为良好到极佳(76%-90%)。对于马从业者来说,了解马因腹痛需要进行探查性剖腹术的适应症和存活率至关重要。马主中普遍存在对存活率低的先入为主观念,主人依赖其主治兽医的建议来决定是否继续转诊至转诊中心以及进行包括探查性剖腹术在内的进一步治疗。