Scoping review: Occurrence and definitions of postoperative complications in equine colic surgery.
Authors: Gandini Marco, Cerullo Anna, Giusto Gessica
Journal: Equine veterinary journal
Summary
# Editorial Summary: Postoperative Complications in Equine Colic Surgery—A Definitional Crisis Equine colic surgery remains a common intervention, yet the profession lacks standardised terminology for documenting and comparing postoperative outcomes, limiting our ability to benchmark surgical success across centres and time periods. Gandini and colleagues conducted a comprehensive scoping review of 272 peer-reviewed studies published between 1992 and 2022, examining how postoperative complications following colic surgery are defined and classified; the cohort encompassed predominantly retrospective designs (predominantly case series and cohort studies) with a median sample size of 53 animals, covering a broad range of intestinal pathologies from small intestine, large intestine, or combined involvement. The findings reveal a troubling absence of standardisation: no included study explicitly defined what constitutes a complication, none referenced an established classification system, and only one addressed definitional distinctions between sequelae, disease progression, and recurrence—with 81 distinct complications identified across inconsistently defined short- and long-term timeframes. For equine surgeons, anaesthetists, and rehabilitation professionals, this inconsistency hampers critical evaluation of surgical technique efficacy, complicates cross-centre comparisons of outcomes, and obscures genuine trends in post-colic recovery management. Adopting consensus definitions and classification frameworks is essential to elevate evidence quality in equine colic surgery and enable practitioners to make informed decisions about surgical approaches and postoperative protocols.
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Practical Takeaways
- •When reviewing colic surgery outcomes or comparing success rates between clinics or time periods, be aware that different studies likely define and classify complications inconsistently—direct comparisons may be misleading
- •Advocate for and adopt standardized complication classification systems in your practice to enable better tracking of surgical efficacy and meaningful communication with referring veterinarians
- •Request that post-operative follow-up protocols clearly define what constitutes a complication, sequela, or recurrence rather than assuming standard definitions are being used
Key Findings
- •Among 272 included studies on equine colic surgery, 26.4% focused on single complications and no study explicitly defined the term 'complication' or cited a classification system
- •Eighty-one different postoperative complications were reported across studies with highly variable definitions, particularly for long-term follow-ups
- •Most studies were retrospective designs (121 cohort studies, 82 case series) with median sample size of 53 animals, and 47% of studies reported complications in both small and large intestinal disease
- •Only one study reported definitions of 'sequela', 'progression' or 'recurrence' of lesions, indicating severe lack of standardized terminology across the literature