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. 2022 Sep;54(5):934-945.
doi: 10.1111/evj.13511. Epub 2021 Oct 6.

Standing flank laparotomy for colic: 37 cases

Marco A F Lopes  1 , Joanne Hardy  2 , Kelly Farnsworth  3 , Raphael Labens  4 , W Y Eunice Lam  1 , Erik Noschka  1 , Tiago Afonso  1 , Claudia Cruz Villagrán  1 , Luiz C P Santos  1 , Montague Saulez  1 , Gal Kelmer  5
Affiliations

Standing flank laparotomy for colic: 37 cases

Marco A F Lopes et al. Equine Vet J. 2022 Sep.

Abstract

Background: 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.

Objective: To report a series of cases of peritoneal and intestinal diseases other than SC diseases managed with standing flank laparotomy.

Study design: Retrospective case series.

Methods: Records from equids with colic subjected to standing flank laparotomy at five hospitals (2003-2020) were reviewed. Descriptive data analysis was performed.

Results: 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.

Main limitations: The retrospective design, lack of a control group, small number of cases and lack of standardised protocols between hospitals.

Conclusions: 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.

Keywords: celiotomy; colic; flank; horse; laparotomy; standing.

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References

REFERENCES

    1. Freeman DE. Surgical exploration and manipulation. In: White NA, Moore JN, Mair TS, editors. The equine acute abdomen. Teton NewMedia, Jackson; 2008. p. 451-72.
    1. Kummer MR. Surgical approaches to the abdomen. In: Auer JA, Stick JA, editors. Equine surgery. Elsevier Saunders; 2012. p. 407-10.
    1. Christophersen MT, Dupont N, Berg-Sorensen KS, Konnerup C, Pihl TH, Andersen PH. Short-term survival and mortality rates in a retrospective study of colic in 1588 Danish horses. Acta Vet Scand. 2014;56:20.
    1. Dugdale AH, Obhrai J, Cripps PJ. Twenty years later: a single-centre, repeat retrospective analysis of equine perioperative mortality and investigation of recovery quality. Vet Anaesth Analg. 2016;43:171-8.
    1. Dearo ACO, Gomes RG, Araujo RG, Reichmann P, Cosenza M, Coneglian MM. Surgical removal of a descending (small) colon foreign body through a secondary paramedian approach. J Equine Vet Sci. 2009;29:155-9.

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