Department of Clinical Sciences, Colorado State University, Fort Collins, CO; Ford Veterinary Surgery Center, Clovis, CA.
Department of Clinical Sciences, Colorado State University, Fort Collins, CO.
J Equine Vet Sci. 2022 Mar;110:103852. doi: 10.1016/j.jevs.2021.103852. Epub 2021 Dec 24.
Surgical repair is frequently effective at resolving uroperitoneum in foals, though complications occur. Despite their occurrence, management strategies used to address these complications, and their impact on survival are not clearly defined. To better describe the complications following surgical correction of uroperitoneum and to document treatment strategies and outcomes after intervention, a multi-center retrospective case series was performed. Medical record data of foals undergoing surgical treatment for uroperitoneum were retrieved from three surgical centers, and cases identified with complications or comorbidities were reviewed. Long-term follow-up was obtained through owner contact. Of 45 foals with uroperitoneum, 13 (29%) had complications or comorbidities following surgical repair. Uroperitoneum recurred in 9 (20%) foals 12-264 hours after surgery. Foals with recurrence were managed medically with an indwelling urinary catheter, repeat celiotomy, or were euthanized. Other comorbidities following repair included sepsis and persistent azotemia. One horse developed cystic calculi 14 months later. Urinary catheters maintained for 3-7 days in combination with medical and surgical interventions successfully resolved uroperitoneum. The decision to debride bladder tear edges or the selection of suture material or pattern did not impact recurrence or survival. Six (67%) foals with recurrent uroperitoneum survived to hospital discharge; 86% survived if treatment was attempted. Four (80%) of cases treated for recurrent uroperitoneum were alive without active medical problems >2 years later. Despite recurrence, medical or surgical treatment of recurrent uroperitoneum enables short-term survival, and maintenance of long-term health. Indwelling urinary catheters should be considered in select cases with recurrent uroperitoneum.
手术修复通常能有效地解决驹腹腔尿外渗问题，但也会出现并发症。尽管存在这些并发症，但针对这些并发症的管理策略及其对存活率的影响尚未明确界定。为了更好地描述手术纠正腹腔尿外渗后的并发症，并记录干预后的治疗策略和结果，进行了一项多中心回顾性病例系列研究。从三个外科中心检索接受手术治疗腹腔尿外渗的驹的病历数据，并对有并发症或合并症的病例进行了回顾。通过与主人联系获得了长期随访。在 45 例腹腔尿外渗驹中，有 13 例（29%）在手术修复后出现并发症或合并症。9 例（20%）驹在手术后 12-264 小时复发腹腔尿外渗。复发驹通过留置导尿管、再次剖腹术或安乐死进行治疗。修复后其他合并症包括败血症和持续性氮血症。1 匹马在 14 个月后发展为囊性结石。留置导尿管 3-7 天，并结合药物和手术干预，成功解决了腹腔尿外渗问题。膀胱撕裂边缘清创或缝合材料或缝合方式的选择并不影响复发或存活率。6 例（67%）复发腹腔尿外渗驹存活至出院；如果尝试治疗，存活率为 86%。4 例（80%）接受复发性腹腔尿外渗治疗的病例在 2 年多后无明显健康问题存活。尽管复发，但对复发性腹腔尿外渗进行药物或手术治疗可实现短期存活，并维持长期健康。在选择有复发性腹腔尿外渗的病例时，应考虑留置导尿管。
