Comparison of short- and long-term complications and survival following jejunojejunostomy, jejunoileostomy and jejunocaecostomy in 112 horses: 2005-2010.
Authors: Stewart S, Southwood L L, Aceto H W
Journal: Equine veterinary journal
Summary
# Editorial Summary When horses require resection of proximal small intestine, surgeons must choose between three anastomotic techniques—jejunojejunostomy (JJ), jejunoileostomy (JI), and jejunocaecostomy (JC)—yet evidence comparing their long-term outcomes remains limited. This retrospective analysis of 112 horses undergoing small intestinal surgery between 2005 and 2010 examined complications and survival across all three techniques, with particular attention to whether JI carried higher short-term mortality (as some surgeons believed) and whether JC's purported link to chronic colic problems was justified. Short-term survival to hospital discharge was comparable across groups (JJ 79%, JI 78%, JC 83%), though JI cases required repeat celiotomy more frequently during hospitalisation. The critical distinction emerged in long-term follow-up: horses receiving JC demonstrated significantly worse survival rates and substantially more post-discharge colic episodes compared to both JJ and JI groups, with euthanasia for colic within 12 months occurring exclusively in JC or repeat-celiotomy cases. These findings challenge the assumption that JI carries unacceptable acute complication rates and instead suggest that when anatomically feasible, jejunoileostomy offers superior long-term outcomes, making it the preferable choice for proximal ileal resection despite requiring careful surgical technique to minimise immediate post-operative complications.
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Practical Takeaways
- •When performing small intestinal anastomosis, jejunoileostomy may be the preferred technique due to superior long-term survival and lower incidence of recurrent colic despite slightly higher rates of repeat surgery during initial hospitalisation
- •Jejunocaecostomy carries significantly worse long-term prognosis and should be reserved for situations where jejunoileostomy is not anatomically feasible
- •Clients should be counselled that while initial discharge rates are good across all techniques (~79-83%), long-term colic risk differs substantially between anastomosis types
Key Findings
- •Short-term hospital discharge survival was similar across all three anastomosis types (JJ 79%, JI 78%, JC 83%, p not significant)
- •Horses undergoing jejunoileostomy had significantly more repeat celiotomies during hospitalisation compared with jejunocaecostomy
- •Long-term survival was significantly lower for jejunocaecostomy compared with jejunojejunostomy or jejunoileostomy (P = 0.04)
- •Post-discharge colic occurred more frequently in horses with jejunocaecostomy than jejunojejunostomy or jejunoileostomy, with euthanasia for colic within 12 months only occurring in JC or repeat celiotomy groups