DESCRIPTIVE CLINICAL REPORT
Surgical lesions of the small colon and post operative survival in a UK hospital population
Article first published online: 23 NOV 2012
© 2012 EVJ Ltd
Equine Veterinary Journal
Volume 45, Issue 4, pages 460–464, July 2013
How to Cite
de Bont, M. P., Proudman, C. J. and Archer, D. C. (2013), Surgical lesions of the small colon and post operative survival in a UK hospital population. Equine Veterinary Journal, 45: 460–464. doi: 10.1111/evj.12005
- Issue published online: 6 JUN 2013
- Article first published online: 23 NOV 2012
- Accepted manuscript online: 15 OCT 2012 08:00AM EST
- Manuscript Accepted: 4 OCT 2012
- Manuscript Received: 24 JUL 2012
- small (descending) colon;
- survival analysis;
- case control
Reasons for performing study
There is limited information about risk factors and survival associated with disorders of the small colon requiring surgical management.
1) To document the types of surgical lesion in horses where pathology of the small (descending) colon was the primary cause of abdominal pain, 2) to describe the short- and long-term survival of these cases and identify factors associated with survival and 3) to identify preoperative variables associated with localisation of a lesion to the small colon.
Clinical data and long-term follow-up were obtained for horses that underwent exploratory laparotomy over a 10-year period. Descriptive data were generated for short- and long-term survival and survival analysis performed to identify factors associated with reduced survival. Univariable and multivariable relationships were explored using a Cox proportional hazards model. Preoperative factors associated with increased likelihood of a small colon lesion were explored, using controls randomly selected from horses undergoing exploratory laparotomy for treatment of colic unrelated to the small colon.
The study population included 84 horses. Of horses with small colon lesions recovered from anaesthesia, the percentage that survived until discharge, one year and 2 years following surgery, was 91.0, 81.0 and 73.5%, respectively. Median survival time for horses in which a resection had been performed was 1029 vs. 3072 days in the nonresection group. Small colon cases were more likely to have shown a longer duration of colic signs prior to admission (P<0.001) and to develop post operative diarrhoea (P = 0.001) when compared with surgical controls.
Lesions of the small colon carry a good prognosis for survival following surgery. Resection and anastomosis was the only factor associated with reduced long-term survival.
This study provides information about lesion types and post operative survival that may be used to assist informed decision-making when managing these cases.