End-to-Side Versus Side-to-Side Jejunocecostomy in Horses: A Retrospective Analysis of 150 Cases

• Published in: Veterinary surgery Vol. 44; no. 4; pp. 527 - 533
• Main Authors: Brown, Jennifer A., Holcombe, Susan J., Southwood, Louise L., Byron, Christopher R., Embertson, Rolf M., Hauptmann, Joe G.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-05-2015
• Subjects: Anastomosis, Surgical - methods; Anastomosis, Surgical - veterinary; Animals; Colic - surgery; Colic - veterinary; Female; Horse Diseases - mortality; Horse Diseases - surgery; Horses; Jejunal Diseases - surgery; Jejunal Diseases - veterinary; Kaplan-Meier Estimate; Logistic Models; Male; Postoperative Complications - veterinary; Retrospective Studies; Surgical outcomes; Surgical Stapling - veterinary; Survival Analysis; Treatment Outcome; United States; Veterinary medicine; United States
• ISSN: 0161-3499; 1532-950X
• DOI: 10.1111/j.1532-950X.2014.12256.x

Objectives
To determine factors associated with postoperative reflux, postoperative colic, repeat celiotomy, and survival in horses after end‐to‐side (E2S) or side‐to‐side (S2S) jejunocecostomy.
Study Design
Retrospective, multicenter study.
Sample Population
Horses (n = 150).
Methods
Admissions, intra‐ and postoperative data were collected from medical records of horses that had E2S or S2S jejunocecostomy. Descriptive statistics were calculated and data were analyzed using parametric and nonparametric tests, linear and multivariate logistic regression with significance set at P < .05. Kaplan–Meier estimate of the survival function was performed.
Results
One hundred fifty horses (S2S = 90, E2S = 60) were included. S2S procedures were performed using staples (n = 57) or hand‐sewn (33). Method of anastomosis was not significantly associated with development of postoperative reflux or colic, repeat celiotomy, whether the horse was alive at hospital discharge or 12 months after discharge. The number of years that the principal surgeon was boarded by the American College of Veterinary Surgeons significantly affected whether the horse was discharged from the hospital alive (P = .003). Age (P = .006) was significantly associated with 12‐month survival. Increased age (P = .013) and administration of prokinetic medication (P = .0006) were significantly associated with development of postoperative reflux. Sixty‐eight (76%) horses with S2S and 52 (87%) horses with E2S were discharged alive.
Conclusion
Age, patient related variables, and surgeon experience may influence morbidity and mortality more than method of jejunocecostomy.