Equis ISSN 2398-2977

Cecocolic anastomosis

Contributor(s): Christopher Brown, Graham Munroe

Introduction

  • Cecal impaction   Cecum: impaction  is a relatively common disease of the cecum involving a primary cecal motility dysfunction over which there is considerable disagreement regarding treatment.
  • Surgical treatment is recommended if the cecum is very large, the impacted digesta hard, medical management is unsuccessful or the impaction is recurrent.
  • Several surgical techniques are available and include typhlotomy   Cecum: typhlotomy  , cecocolic anastomosis and jejunocolic/ileocolic anastomosis   Jejunocolic / ileocolic anastomosis  .
  • Cecocolic anastomosis provides an alternative route of digesta transit from the cecum to the right ventral colon.

Uses

  • Surgical treatment of cecal impaction   Cecum: impaction  to avert possible post-operative complications of recurrent impaction and subsequent perforation.
  • Generally combined with typhlotomy   Cecum: typhlotomy  and evacuation of cecal contents.

Advantages

  • Highly successful particularly in preventing recurrence of impaction.

Disadvantages

  • Technically demanding.
  • Generally easier to perform if stapling instruments are used - these are expensive.
  • Not a suitable technique if the cecal wall is compromized.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • See: cecal impaction   Cecum: impaction  .
  • The original description of the technique reported:
    • 12 of 14 horses (86%) survived 2 months or longer.
    • 10 horses (71%) survived longer than 1 year.
    • 4 horses had intermittent colic related to gas distention of the cecum or large colon but no recurrent cecal impaction was detected.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Dabareiner R M and White N A (1997) Diseases and surgery of the cecum. Vet Clin North Am Equine Pract 13 (2), 303-315 PubMed.
  • Mueller P O and Allen D (1996) Instrumentation and techniques in equine gastrointestinal surgery. Vet Clin North Am Equine Pract 12 (2), 207-233 PubMed.
  • Ross M W (1989) Surgical disease of the equine cecum. Vet Clin North Am Equine Pract (2), 363-375 PubMed.
  • Ross M W, Tate L P and Donawick W J (1986) Cecocolic anastomosis for the surgical management of cecal impactions in horses. Vet Surg 15 (1), 85-92 VetMedResource.


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