Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 4: Early (acute) relaparotomy.
Authors: Mair T S, Smith L J
Journal: Equine veterinary journal
Summary
# Editorial Summary: Acute Relaparotomy Following Colic Surgery Approximately one in ten horses undergoing colic surgery requires acute relaparotomy to manage post-operative complications such as persistent pain, ileus, peritonitis or wound breakdown, yet limited data exist on outcomes and complication rates to guide clinical decision-making and owner counselling. This retrospective review of 300 consecutive colic cases (1994–2001) documented that 27 horses underwent early relaparotomy, with 77.8% surviving the second surgery but only 48.2% (13 horses) successfully discharged from hospital. Disturbingly, long-term survival was substantially poorer at just 22.2%, and nearly 70% of discharged horses subsequently experienced further colic episodes, with 38.5% requiring additional surgical intervention. The findings underscore that whilst acute relaparotomy may be necessary to address life-threatening post-operative complications, clinicians and owners must understand the guarded prognosis associated with this escalation of care, with realistic expectations set regarding both immediate recovery and long-term quality of life. Given the high morbidity and recurrence rate, careful assessment of the primary pathology, surgical findings and individual horse factors should guide the decision to proceed to relaparotomy rather than considering it a routine salvage procedure.
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Practical Takeaways
- •When counselling owners before colic surgery, advise that approximately 1 in 10 horses may require urgent re-surgery, with poor long-term prognosis (22% survival)
- •Relaparotomy should be considered for persistent post-operative pain, ileus, peritonitis, or wound breakdown, but owners must understand high complication and recurrence rates
- •Horses surviving relaparotomy require intensive post-operative monitoring and management, as nearly 40% will need further surgical intervention for recurrent colic
Key Findings
- •Acute relaparotomy was performed in 10.6% (27/254) of horses recovering from initial colic surgery
- •Short-term survival rate after relaparotomy was approximately 50%, with long-term survival of only 22.2%
- •Persistent pain and post-operative ileus were the most common indications for relaparotomy
- •69.2% of horses discharged after relaparotomy developed subsequent colic episodes, with 38.5% requiring further surgery