Technique-associated outcomes in horses following large colon resection.
Authors: Pezzanite Lynn M, Hackett Eileen S
Journal: Veterinary surgery : VS
Summary
# Large Colon Resection: Anastomosis Technique Shows No Impact on Survival When large colon disease necessitates resection in horses, surgeons must choose between sutured end-to-end or stapled functional end-to-end anastomoses, yet limited evidence exists to guide this decision. Pezzanite and Hackett analysed 26 horses (14 sutured, 12 stapled) undergoing colectomy between 2003 and 2016, tracking survival to discharge, hospitalisation duration, and long-term outcomes through owner follow-up. Both techniques demonstrated comparable results: 12 of 14 sutured horses and 9 of 12 stapled horses survived to discharge (P = 0.63), with mean hospitalisation times around 9 days regardless of method, and no difference in long-term survival curves (P = 0.35). For equine surgeons, this equivalence suggests that anastomosis choice can be guided by individual case factors, surgeon familiarity, and patient anatomy rather than outcome concerns—a reassuring finding given that colectomy remains a high-stakes procedure in geriatric horses (mean age 13 years) undergoing either prophylactic or salvage interventions. Whilst the relatively small cohort size merits cautious interpretation, the findings support either technique as a defensible surgical approach in this challenging population.
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Practical Takeaways
- •Surgeons can confidently choose either sutured or stapled anastomosis technique for large colon resection based on individual case factors and surgeon preference, as both yield equivalent survival outcomes
- •Expected hospitalization averages 9 days regardless of anastomosis method; counsel owners accordingly for planning and costs
- •Both prophylactic and salvage colectomies showed similar outcomes, suggesting technique rather than indication is the relevant surgical variable
Key Findings
- •75% of stapled anastomosis horses (9/12) and 86% of sutured anastomosis horses (12/14) survived to hospital discharge with no significant difference (P=0.63)
- •Mean surgical time was 169 minutes with mean hospitalization of 9 days, not differing by anastomosis type (P=0.62)
- •Long-term survival time did not differ between sutured end-to-end and stapled functional end-to-end anastomosis techniques (P=0.35)
- •Both techniques showed comparable short- and long-term outcomes in horses undergoing colectomy