School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK.
B&W Equine Hospital, Berkeley, UK.
Equine Vet J. 2024 Nov;56(6):1115-1128. doi: 10.1111/evj.14122. Epub 2024 Jul 12.
Castration is the most common surgical procedure in domesticated equids; surgical techniques used and perioperative management vary considerably.
To identify and chart the current evidence on perioperative complications associated with different methods of surgical castration in domesticated equids.
Joanna Briggs Institute systematic scoping review.
CAB Abstracts, Medline and Embase databases were searched using terms related to equine castration complications. Two authors independently and blindly screened publications against eligibility criteria. Data on study methods, perioperative management, surgical techniques, and perioperative complications were extracted. Surgical techniques were grouped into categories depending on technique; open, closed or half-closed, and whether the parietal tunic was open or closed at the end of surgery.
The search identified 1871 publications; 71 studies met the final inclusion criteria. The data reported 76 734 castrations, most of which were open or closed, with the vaginal tunic remaining open at the end of surgery. Twenty-five studies reported information regarding surgical techniques and perioperative management, allowing detailed charting and comparisons, of which analgesia and antimicrobial usage varied notably. Eighteen different complications were reported, with swelling or oedema being the most common. Evisceration was most commonly reported in draught breeds and Standardbreds, and the risk appeared low if the parietal tunic was closed at the end of surgery.
Grey literature and studies not available in English were not included. Existing studies varied greatly in perioperative management, surgical techniques and reporting of outcomes, making evidence consolidation problematic.
A lack of consensus regarding complication definitions creates uncertainty and discrepancies between complication rates associated with different surgical techniques and perioperative management. The implementation of standardised systems for describing surgical techniques and complications is recommended for future studies. A number of studies did not follow current recommendations for perioperative analgesia and use of antimicrobials.
去势是家马最常见的外科手术；所使用的手术技术和围手术期管理差异很大。
确定并绘制与家马不同去势手术方法相关的围手术期并发症的当前证据。
乔安娜·布里格斯研究所系统范围审查。
使用与马去势并发症相关的术语，对 CAB 摘要、Medline 和 Embase 数据库进行搜索。两名作者独立且盲目地根据入选标准筛选出版物。提取有关研究方法、围手术期管理、手术技术和围手术期并发症的数据。根据技术将手术技术分为几类；开放式、封闭式或半封闭式，以及手术结束时壁层胎膜是否开放。
搜索共确定了 1871 篇出版物；71 项研究符合最终纳入标准。这些数据报告了 76734 例去势手术，其中大部分为开放式或封闭式，手术结束时阴道胎膜保持开放。有 25 项研究报告了关于手术技术和围手术期管理的信息，允许详细制图和比较，其中镇痛和抗菌药物的使用差异显著。报告了 18 种不同的并发症，肿胀或水肿最为常见。内脏脱出最常发生在役用品种和标准品种中，如果手术结束时壁层胎膜闭合，风险似乎较低。
未包括灰色文献和英文以外的研究。现有的研究在围手术期管理、手术技术和结果报告方面差异很大，使得证据整合变得困难。
缺乏关于并发症定义的共识，导致与不同手术技术和围手术期管理相关的并发症发生率存在不确定性和差异。建议为未来的研究采用标准化系统来描述手术技术和并发症。一些研究没有遵循当前围手术期镇痛和使用抗菌药物的建议。
