Occurrence and Definitions of Intra and Postoperative Complications Related to Laparoscopy in Equids: A Scoping Review

SIMPLE SUMMARY: Laparoscopy and laparoscopic-assisted procedures in equines are nowadays common procedures with several advantages compared to laparotomy. However, despite the numerous benefits of minimally invasive surgery, there can be surgical complications which could have important welfare and economic consequences. Nevertheless, standard definitions of intra and postoperative complications are rarely reported and there is a lack of standard criteria to define and classify complications, limiting comparison of complication rates between studies. Thus, there is a need for implementation of rigorous criteria for defining complications and for greater numbers of research study with high quality of evidence. Adoption of classification systems and standard definitions would help surgeons to have a complete picture of the efficacy of a procedure or treatment and it is also essential to allow comparisons between studies, centers or time periods. ABSTRACT: Laparoscopy is a common approach in equine surgery and has the advantage of improved visibility and diagnostic accuracy, decreased morbidity and hospitalization time. However, despite the numerous benefits, there can be intraoperative and postoperative complications which could have important welfare and economic consequences. The aim of this study was to perform a scoping review to identify current evidence on the occurrence, definition and classification of intra and postoperative complications in equine laparoscopy. A scoping review was conducted in scientific databases. Peer-reviewed scientific articles in the English language on laparoscopy in equids between 1992 and 2022 were included. Data on the study method, sample size, surgical procedure, intra and postoperative complications were extracted and charted. One hundred sixty-four articles met the final inclusion criteria. A definition of “intraoperative complication” was given in one study. Difference between “minor” or “major” intraoperative complications were reported in 12 articles and between “minor” or “major” postoperative complications in 22 articles. A total of 22 intraoperative and 34 postoperative complications were described. The most reported intraoperative complication was hemorrhage from ovary or mesovary (12.7%), while the most reported postoperative complications were incisional complications (64.2%) and postoperative pain (32.7%). There is a need for implementation of criteria for defining complications. The adoption of classification systems and standard definitions would help surgeons to make decisions about the most appropriate treatment, and it is also essential to allow comparisons between research results

Short-Term Survival and Postoperative Complications Ratesin Horses Undergoing Colic Surgery: A Multicentre Study

The occurrence of colic could be influenced by the characteristics of a population, geograph-ical area, and feeding management. The aim of this study was to report the short-term postoperativecomplications and survival rates and to identify factors that might affect the outcome of horses thatunderwent colic surgery in three Italian surgical referral centres. Data of horses subjected to colicsurgery in three referral centres (2018–2021) were analysed. Comparisons of the outcomes wereperformed using a Mann–Whitney or a Chi square test. Areas under the receiver operating character-istic (ROC) curve and multivariable logistic regression analysis were used for parameters that weresignificant in the previous univariate analysis. The goodness-of-fit of the model was assessed usingthe Akike information criterion (AIC). Significance was defined asp< 0.05, and odds ratios and 95%confidence intervals were calculated as percentages. A total of 451 horses were included. The survivalrate was 68.5% of all of the horses that underwent colic surgery and 80% of the horses survivinganaesthesia. Age, BCS, PCV and TPP before and after surgery, amount of reflux, type of disease, typeof lesion, duration of surgery, surgeon’s experience, and amount of intra- and postoperative fluidsadministered influenced the probability of short-term survival. The multivariate analysis revealedthat PCV at arrival, TPP after surgery, and BCS had the highest predictive power. This is the firstmulticentre study in Italy. The results of this study may help surgeons to inform owners regardingthe prognosis of colic surgery