34th Annual Scientific Meeting proceedings

Objectives:

Long-term assessments of nephrosplenic space (NSS) closure and comparisons with ultrasonography and rectal palpation are lacking. The objective of this study was to assess the NSS 5 years after laparoscopic ablation for adhesions, and their correlation with rectal examination and ultrasonography findings.

Methods:

The NSS of 11 research horses was examined via rectal and ultrasound examination prior to laparoscopic ablation of the space, and at 30 days (t30) and 5 years (t5y) post-operatively. Ultrasonographic measurements of the cranial and caudal distances between the renal fascia and spleen were taken. Laparoscopy was performed 5 years post-operatively and NSS adhesions were scored and correlated with ultrasound and rectal findings. Additionally, intra-operative surgical ablation factors were tested as predictors for satisfactory adhesions. Results were analysed through logistic regression (P<.05).

Results:

Two horses had adhesions in less than 25% of NSS, which were unsatisfactory for preventing colon entrapment. The remaining horses had strong adhesions in greater than 50% of NSS. Rectal palpation indicated adhesion presence (P=.047). There was no predictive effect of ultrasonographic measurements taken caudally at t30 (P=.86) or t5y (P=.61) on satisfactory adhesion. Cranial measurements could not be included in the analysis because bowel interference precluded data acquisition. Surgery time, number of suture bites or bleeding did not predict a satisfactory adhesion.

Conclusions:

Nine of 11 horses had satisfactory adhesions. Rectal examination findings effectively predicted the presence of adhesions. Discrepancies between ultrasonography assessments and laparoscopic adhesion scores suggests limitations in the usefulness of ultrasonography for evaluating adhesions.