Equine Health and Performance Centre, School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, South Australia, Australia.
Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA.
Equine Vet J. 2022 Sep;54(5):934-945. doi: 10.1111/evj.13511. Epub 2021 Oct 6.
Standing flank laparotomy can be an alternative to ventral midline laparotomy in horses with colic. Standing flank laparotomy avoids general anaesthesia, provides excellent access to some regions of the abdominopelvic cavity and costs less than ventral midline laparotomy.
To report a series of cases of peritoneal and intestinal diseases other than SC diseases managed with standing flank laparotomy.
Retrospective case series.
Records from equids with colic subjected to standing flank laparotomy at five hospitals (2003-2020) were reviewed. Descriptive data analysis was performed.
Thirty horses (sixteen survived to discharge), six ponies (four survived) and one donkey (euthanised) were subjected to standing flank laparotomy via the left flank (n = 31), right flank (n = 2) or both flanks (n = 4). The primary disease affected the peritoneum (0/5 survived), SI (5/9 survived) and caecum and/or LC (15/23 survived). Enterotomy was performed in four animals (all survived). Partial typhlectomy was performed in one horse (euthanised). Resection-anastomosis of the SI or LC was performed in three animals (one survived). Three animals had intraoperative complications that negatively affected the outcome: Two ponies had intolerance to abdominopelvic exploration; one mare had spontaneous exteriorisation of a long segment of the SI leading to a large tear in the mesentery. In seven cases, severe/extensive lesions found during standing flank laparotomy warranted immediate euthanasia. The survival rate was 54%. All owners were satisfied with the decision to perform standing flank laparotomy.
The retrospective design, lack of a control group, small number of cases and lack of standardised protocols between hospitals.
Although ventral midline laparotomy is the standard of care for horses with colic, standing flank laparotomy is a viable approach for some types of colic. Systemic administration of analgesics may not produce sufficient peritoneal analgesia, which can lead to intolerance to abdominopelvic exploration during standing flank laparotomy in horses with colic and may negatively affect the outcome.
在患有腹痛的马中，侧卧位剖腹术可以替代腹中线剖腹术。侧卧位剖腹术避免了全身麻醉，为腹腔和盆腔的一些区域提供了极好的通路，并且比腹中线剖腹术成本更低。
报告一系列除 SC 疾病以外的腹膜和肠道疾病，这些疾病通过侧卧位剖腹术进行治疗。
回顾性病例系列研究。
对五家医院（2003-2020 年）接受侧卧位剖腹术治疗的患有腹痛的马的病例进行了回顾性分析。进行了描述性数据分析。
30 匹马（16 匹存活至出院）、6 匹矮种马（4 匹存活）和 1 头驴（安乐死）通过左肋部（n=31）、右肋部（n=2）或双侧肋部（n=4）接受了侧卧位剖腹术。主要疾病影响腹膜（5/5 例均死亡）、回肠（9/9 例存活）和盲肠和/或 LC（23/23 例存活）。4 例动物进行了肠切开术（均存活）。1 匹马进行了部分回肠切除术（安乐死）。3 例动物进行了回肠或 LC 的切除吻合术（1 例存活）。3 例动物在手术过程中出现了并发症，对预后产生了负面影响：2 匹矮种马对腹部探查不耐受；1 匹母马自发地将一段很长的回肠排出，导致肠系膜出现大的撕裂。在 7 例病例中，侧卧位剖腹术中发现的严重/广泛病变需要立即安乐死。存活率为 54%。所有主人对进行侧卧位剖腹术的决定感到满意。
回顾性设计、缺乏对照组、病例数量少以及医院之间缺乏标准化方案。
虽然腹中线剖腹术是治疗腹痛马的标准方法，但对于某些类型的腹痛，侧卧位剖腹术是一种可行的方法。全身给予镇痛药可能无法产生足够的腹膜镇痛，这可能导致腹痛马在进行侧卧位剖腹术时对腹部探查不耐受，并可能对预后产生负面影响。
