End-to-Side Versus Side-to-Side Jejunocecostomy in Horses: A Retrospective Analysis of 150 Cases

ObjectivesTo determine factors associated with postoperative reflux, postoperative colic, repeat celiotomy, and survival in horses after end-to-side (E2S) or side-to-side (S2S) jejunocecostomy. Study DesignRetrospective, multicenter study. Sample PopulationHorses (n=150). MethodsAdmissions, intra- and postoperative data were collected from medical records of horses that had E2S or S2S jejunocecostomy. Descriptive statistics were calculated and data were analyzed using parametric and nonparametric tests, linear and multivariate logistic regression with significance set at P<.05. Kaplan-Meier estimate of the survival function was performed. ResultsOne hundred fifty horses (S2S=90, E2S=60) were included. S2S procedures were performed using staples (n=57) or hand-sewn (33). Method of anastomosis was not significantly associated with development of postoperative reflux or colic, repeat celiotomy, whether the horse was alive at hospital discharge or 12 months after discharge. The number of years that the principal surgeon was boarded by the American College of Veterinary Surgeons significantly affected whether the horse was discharged from the hospital alive (P=.003). Age (P=.006) was significantly associated with 12-month survival. Increased age (P=.013) and administration of prokinetic medication (P=.0006) were significantly associated with development of postoperative reflux. Sixty-eight (76%) horses with S2S and 52 (87%) horses with E2S were discharged alive. ConclusionAge, patient related variables, and surgeon experience may influence morbidity and mortality more than method of jejunocecostomy.