Pye Jannah, Espinosa-Mur Pablo, Roca Rodrigo, Kilcoyne Isabelle, Nieto Jorge, Dechant Julie
William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, California.
Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California.
Vet Surg. 2019 Jul;48(5):786-794. doi: 10.1111/vsu.13184. Epub 2019 Mar 4.
To determine if preoperative and intraoperative clinical variables correlate with resection and anastomosis (RA) in horses presenting with strangulating small intestinal (SI) lesions.
Retrospective case series.
Horses undergoing exploratory celiotomy for a strangulating SI lesion (n = 243).
The records of horses undergoing surgical correction for strangulating SI lesions from January 1, 2000 to December 31, 2017 were reviewed. Horses were categorized as treated with RA or not treated with RA. Obtained information included history, signalment, clinical findings, diagnostic test results, intraoperative findings, and survival to discharge. Univariable and multivariable analyses were used to compare data between horses treated with RA vs those not treated with RA (P = .05).
In total, 172 SI lesions were resected, and 71 were not resected. Horses that had gastric reflux at admission to the hospital (odds ratio [OR] 5.56; 95% CI 1.76, 17.59) and horses with amotile SI according to abdominal ultrasonography (OR 9.69; 95% CI 3.09, 30.37) were more likely to undergo RA. Increased difference between peritoneal fluid and blood lactate was higher in horses that underwent RA (OR 1.55; 95% CI 1.12, 2.13). Survival to hospital discharge was lower in the group of horses that underwent RA compared with horses that did not undergo RA.
Resection and anastomosis of strangulating SI lesions was associated with several preoperative variables.
This study highlights the value of preoperative diagnostic procedures in aiding intraoperative decision making and prognostication in horses presenting with strangulating SI lesions.
确定患有绞窄性小肠（SI）病变的马匹术前和术中临床变量是否与切除吻合术（RA）相关。
回顾性病例系列研究。
因绞窄性SI病变接受剖腹探查术的马匹（n = 243）。
回顾2000年1月1日至2017年12月31日因绞窄性SI病变接受手术矫正的马匹记录。将马匹分为接受RA治疗或未接受RA治疗两组。获取的信息包括病史、特征、临床发现、诊断测试结果、术中发现以及出院存活率。采用单变量和多变量分析比较接受RA治疗与未接受RA治疗的马匹的数据（P = 0.05）。
总共切除了172处SI病变，71处未切除。入院时出现胃反流的马匹（优势比[OR] 5.56；95%置信区间1.76，17.59）以及根据腹部超声显示小肠无蠕动的马匹（OR 9.69；95%置信区间3.09，30.3７）更有可能接受RA。接受RA的马匹腹腔液与血液乳酸之间的差异增加更为明显（OR 1.55；95%置信区间1.12，2.13）。与未接受RA的马匹相比，接受RA的马匹出院存活率较低。
绞窄性SI病变的切除吻合术与多个术前变量相关。
本研究强调了术前诊断程序在辅助患有绞窄性SI病变马匹的术中决策和预后评估方面的价值。
