Horses experiencing severe gastrointestinal compromise from strangulating large colon volvulus and/or intestinal necrosis need surgery to remove the diseased bowel. Resection of the large colon (colectomy) and anastomosis with the remaining healthy segments is a common surgical procedure in horses undergoing colic surgery.
A retrospective study at Colorado State University looked at the difference in outcomes between stapling and suturing the end-to-end anastomoses in cases presented between 2003-2016 [Pezzanite, L.M. and Hackett, E.S. Technique-associated outcomes in horses following large colon resection. Veterinary Surgery, 2017; 1-7].
Stapled functional end-to-end anastomosis was performed in 12 horses while 14 received a sutured technique. Stapling is thought to reduce surgical time and anesthesia, which is beneficial to the horse. However, concerns have been raised that staples might result in dehiscence and/or staple size might be inappropriate for compromised bowel. This study set out to look at results comparing outcomes using these two procedures.
Of the 26 horses undergoing colectomy surgery, 21 were discharged and five were euthanized prior to discharge. For those with the stapled anastomosis 75% (9/12) were discharged; those with a sutured anastomosis 86% (12/14) were successfully discharged. Euthanasia was necessitated in the five cases due to persistent colic, endotoxemia or peritonitis.
The horses were followed for as much as 4¾ years post-operatively. Of the 21 discharged horses, 14 (67%) were doing well. One horse from each surgical technique was subsequently euthanized due to later dehiscence of the anastomosis and peritonitis. Five other horses were euthanized due to unrelated problems.
The study reported that the use of either technique—stapling or suturing of the end-to-end anastomosis—colectomy did not differ in outcomes for either short-or long-term survival.