Equis ISSN 2398-2977

Colon: resection

Contributor(s): Graham Munroe

Introduction

  • There are a number of indications for colon resection in the horse.
  • Up to 95% of the large colon is resectable but only lesions up to the level of the cecocolic ligament are exteriorisable from the ventral midline laparotomy   Abdomen: surgical approaches  .
  • Lesions in the terminal right dorsal colon and oral right ventral colon are not removable.
  • Horses in which 60% of the colon is removed experience adaptive changes and return to normal gut function within 5-6 months.
  • Resections > 60% partially adapt but require diets such as alfalfa hay to maintain weight.
  • Fecal bulk increases due to fecal water increase and subsequent increase in water consumption.
  • Localized lesions may be amenable to selective resection and end-to-end anastomosis by hand suturing .
  • Greater amounts of resection require a side-to-side anastomosis with closure of the ends of the dorsal and ventral colons - may be performed by hand suturing or surgical stapling techniques .

Uses

  • Strangulation obstruction of large colon usually due to colonic volvulus   Colon: torsion  .
  • Intramural lesions of the colon , eg eosinophilic granulomas, hematomas, fibrotic plaques, ulcerative lesions   →   persistent functional obstruction.
  • Focal strictures   Gastrointestinal: stricture  .
  • Mural devitalization due to long-standing obstructions eg impactions   Colon: impaction  , entero/fecoliths   Gastrointestinal: enterolith  .

Advantages

  • Stapling equipment considerably reduces time for resection and decreases contamination.

Disadvantages

  • Not all of large colon is exteriorisable or resectable.
  • Resection at cecocolic junction is feasible but involves considerable problems and risks.
  • Only small resections are amenable to end-to-end anastomosis.
  • Stapling equipment is expensive and does not work well with thickened tissues.

Requirements

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Preparation

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Procedure

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Outcomes

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Prognosis

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Debareiner, R M, Sullins, K E & Goodrich, L R (1996) Large colon resection for treatment of lymphosarcoma in two horses. J Am Vet Med Assoc 208 (6) 895-897 PubMed.
  • Rose P L, Bradley W M (1992) Resection and anastomosis for treatment of stangulating volvulus of the large colon of horses. JAVMA 201 (3), 454-457 PubMed.


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