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

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, in...

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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
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Abstract	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.
AbstractList	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. 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. Retrospective, multicenter study. Horses (n = 150). 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. 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. Age, patient related variables, and surgeon experience may influence morbidity and mortality more than method of jejunocecostomy. 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. OBJECTIVESTo 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 DESIGNRetrospective, multicenter study.SAMPLE POPULATIONHorses (n = 150).METHODSAdmissions, 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.RESULTSOne 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.CONCLUSIONAge, patient related variables, and surgeon experience may influence morbidity and mortality more than method of jejunocecostomy.
Author	Holcombe, Susan J. Byron, Christopher R. Brown, Jennifer A. Southwood, Louise L. Embertson, Rolf M. Hauptmann, Joe G.
Author_xml	– sequence: 1 givenname: Jennifer A. surname: Brown fullname: Brown, Jennifer A. organization: Marion DuPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Polytechnic and State University, Virginia, Leesburg – sequence: 2 givenname: Susan J. surname: Holcombe fullname: Holcombe, Susan J. email: Susan J. Holcombe, VMD, PhD, Diplomate ACVS & ACVECC, Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824., holcombe@cvm.msu.edu organization: Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, Michigan, East Lansing – sequence: 3 givenname: Louise L. surname: Southwood fullname: Southwood, Louise L. organization: Department of Clinical Studies New Bolton Center, University of Pennsylvania, Pennsylvania, Kennett Square – sequence: 4 givenname: Christopher R. surname: Byron fullname: Byron, Christopher R. organization: Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Illinois, Urbana – sequence: 5 givenname: Rolf M. surname: Embertson fullname: Embertson, Rolf M. organization: Rood and Riddle Equine Hospital, Kentucky, Lexington – sequence: 6 givenname: Joe G. surname: Hauptmann fullname: Hauptmann, Joe G. organization: Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, Michigan, East Lansing
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Snippet	Objectives To determine factors associated with postoperative reflux, postoperative colic, repeat celiotomy, and survival in horses after end‐to‐side (E2S) or... To determine factors associated with postoperative reflux, postoperative colic, repeat celiotomy, and survival in horses after end-to-side (E2S) or... Objectives To determine factors associated with postoperative reflux, postoperative colic, repeat celiotomy, and survival in horses after end-to-side (E2S) or... OBJECTIVESTo determine factors associated with postoperative reflux, postoperative colic, repeat celiotomy, and survival in horses after end-to-side (E2S) or...
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SubjectTerms	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
Title	End-to-Side Versus Side-to-Side Jejunocecostomy in Horses: A Retrospective Analysis of 150 Cases
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