Department of Clinical Sciences (Companion Animals and Equids), Faculty of Veterinary Medicine, Equine Clinic, Liege University, Liege, Belgium
FARAH Research Unit, Liege University, Liege, Belgium.
Vet Rec. 2020 Sep 19;187(6):e43. doi: 10.1136/vr.105684. Epub 2020 May 15.
Epiploic foramen entrapment (EFE) of small intestine is a severe cause of strangulating small intestinal obstruction (SSI) with long-term survival seeming lower than for other causes of SSI in horses. Different techniques via laparoscopy or laparotomy for epiploic foramen (EF) closure have been developed.
This study describes a technique of peroperative mesh closure of the EF in clinical cases and their long-term follow up.
In the study period of 5.5 years, 36 horses were admitted to the clinic with EFE. Of these, 17 horses had peroperative mesh closure, with resection anastomosis in 4 cases and enterotomy in 4 other cases. Fifteen of these survived to discharge. Long-term follow-up (one to three years, median three years) was favourable in all 15 horses not showing recurrence of EFE nor other related signs of colic. Laparoscopic evaluation of the EF was performed in two cases and showed integration of the mesh. One horse was euthanased 3.5 years after mesh placement for an unrelated cause and the mesh was well adherent obliterating the EF.
Mesh closure of EF during emergency coeliotomy did not cause short-term complications even in horses with resection or enterotomy and may reduce the risk of recurrence of EFE in horses.
盲肠孔嵌闭(EFE)是一种严重的绞窄性小肠梗阻(SSI)的原因,其长期存活率似乎低于其他原因导致的马 SSIs。已经开发了通过腹腔镜或剖腹术进行盲肠孔(EF)闭合的不同技术。
本研究描述了一种在临床病例中经手术用网片闭合 EF 的技术及其长期随访情况。
在 5.5 年的研究期间,有 36 匹马因 EFE 而住院。其中 17 例进行了术中网片闭合,4 例进行了切除术吻合,4 例进行了肠切开术。其中 15 例存活至出院。在所有 15 例未出现 EFE 复发或其他相关绞痛迹象的病例中,进行了长达 1 至 3 年(中位数 3 年)的长期随访,结果均良好。在 2 例中进行了 EF 的腹腔镜评估,显示网片已融合。1 匹马因与网片无关的原因在放置网片 3.5 年后被安乐死,网片贴合良好,盲肠孔已被封闭。
即使在进行了切除术或肠切开术的马中,在紧急剖腹术时用网片闭合 EF 也不会导致短期并发症,并且可能降低 EFE 复发的风险。