Abstract
Simple SummaryThe entrapment of the left large colon in the nephrosplenic space is a common cause of colic in horses but not in miniature horses and pony breeds. Different techniques have been proposed to prevent this problem, such as colopexy, large colon resection or nephrosplenic space (NSS) ablation. The most recent methods involve closing the NSS with a minimally invasive technique with the horse standing. Multiple techniques have been described for laparoscopic NSS ablation, among which are ablation with a barbed suture and ablation with prosthetic mesh. Although these two methods have been proposed as valid and effective, no direct comparison has yet been made between them. In this study, the two techniques are compared in terms of duration of surgery, short- and long-term complications, and costs.Nephrosplenic space (NSS) ablation has been demonstrated to be an effective technique for prevention of left dorsal displacement of the large colon and multiple laparoscopic techniques, among which ablation with mesh or with a barbed suture, have been proposed. Our objective was to compare two laparoscopic techniques for closure of the NSS in twenty-eight horses diagnosed with nephrosplenic entrapment. Medical records of horses that had laparoscopic NSS ablation in two referral centers between 2017–2019 were retrieved. Duration of surgery, complications, and short- and long-term follow-up information were collected and compared. Costs were also calculated and compared. All horses met the inclusion criteria: 9 had NSS ablation with a mesh implant (group M), 19 with barbed suture material (group B). One horse in group B had recurrent colic after discharge. At control laparoscopy after 5 months, the NSS resulted in still not being ablated because of a failure of the suture. In group M, three horses had recurrent colic. One was successfully treated medically, one died of unknown causes and the third required a second laparoscopic suturing at 3–6 months because of failure of the mesh implant. The mean time of surgery and costs were lower in group B compared to group M. The barbed suture technique was faster, more cost-effective and had a lower complication rate than the mesh implant.
Highlights
Left dorsal displacement of the left large colon (LDDLC) is one of the displacement of the large colon in horses but not in miniature horses and pony breeds [1,2,3]
Medical records of horses diagnosed with LDDLC at the Large Animal Teaching
Group B included horses in which Nephrosplenic space (NSS) was obliterated with barbed suture (n = 19), and group M included horses in which NSS was obliterated with mesh (n = 9)
Summary
Left dorsal displacement of the left large colon (LDDLC) is one of the displacement of the large colon in horses but not in miniature horses and pony breeds [1,2,3]. A great variability in the recurrence rate of LDDLC is described and ranges between 3.2% and 20.7% [6,8]. Surgical interventions that can prevent the recurrence of this displacement are colopexy, partial resection of the colon and closure of the NSS [8,9]. The reported surgical techniques include ventral laparotomy or flank laparotomy in general anesthesia or with the horse standing, and laparoscopy [5]
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