Survival and complications after large colon resection and end-to-end anastomosis for strangulating large colon volvulus in seventy-three horses.
Authors: Ellis Christina M, Lynch Timothy M, Slone Donnie E, Hughes Faith E, Clark Carol K
Journal: Veterinary surgery : VS
Summary
# Large Colon Resection for Volvulus: Long-term Outcomes in 73 Cases Strangulating large colon volvulus is a life-threatening surgical emergency, but information on long-term consequences of resection and anastomosis remains limited. Between 1995 and 2005, Ellis and colleagues reviewed 73 horses undergoing large colon resection for this condition, examining short- and long-term survival rates alongside complications, using multivariate analysis to identify prognostic factors from readily available admission parameters (age, vital signs, haematological values, breed and sex). Seventy-four per cent of horses survived to discharge, with survival rates remaining stable at approximately 68%, 66%, and 64% at one, two, and three years respectively; notably, pre-operative variables examined—including heart rate, packed cell volume, total plasma protein and white blood cell count—showed no significant association with survival outcome, and post-operative diarrhea, whilst common, proved self-limiting rather than life-threatening. The clinical significance lies in counselling owners that successful hospital discharge is a reliable indicator of good prognosis, and that horses surviving the immediate perioperative period return to their intended uses (breeding, racing, showing) without chronic sequelae or reduced quality of life, suggesting end-to-end anastomosis represents a viable surgical approach despite the severity of the initial condition.
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Practical Takeaways
- •Large colon resection and anastomosis for strangulating volvulus can be performed with reasonable short-term (74%) and long-term survival rates; horses that survive to discharge have good prognosis for functional recovery and return to work
- •Postoperative diarrhea is common but self-limiting and should not be considered a negative prognostic indicator
- •Traditional admission parameters (age, vital signs, bloodwork values) do not reliably predict which horses will survive, so treatment decisions should not be based solely on these factors
Key Findings
- •Short-term survival rate (to discharge) was 74%, with overall survival rates at 1, 2, and 3 years postoperatively of 67.8%, 66.0%, and 63.5% respectively
- •Diarrhea was the most common postoperative complication following large colon resection and anastomosis
- •None of the 9 variables examined (admission date, age, temperature, heart rate, packed cell volume, total plasma protein, white blood cell count, breed, sex) were significantly associated with survival time
- •All 40 horses surviving long-term (>1 year) returned to their intended use with no chronic problems related to the surgical procedure