Scoping review: Occurrence and definitions of postoperative complications in equine colic surgery.

Background: Postoperative complications frequently occur following equine colic surgery but there is a lack of consistency in their definitions and reporting.

Objectives: To perform a scoping review to identify current evidence on the definitions and classifications of postoperative complications in equine colic surgery.

Study Design: Evidence review.

Methods: A scoping review was conducted in CAB, Web of Science, Scopus and PubMed databases using a PCC (Population-equids, Concept-complications, adverse events, sequelae, failure to cure, technical failure, disease progression and Context-postoperative period after colic surgery) search strategy. Peer-reviewed scientific articles in the English language on equine colic surgery in live client-owned equids between 1992 and 2022 were included. The resulting references were independently and blindly screened by two investigators. Relevant data on the study method, sample size, intestinal tract involvement and postoperative complications were extracted and charted.

Results: Among 5850 articles potentially eligible, 272 met the final inclusion criteria. The most frequent types of study design were retrospective cohort studies (121/272) and retrospective case series (82/272). Median sample size was 53 animals, range 3-896. Seventy-nine of 272 (29%) studies reported diseases of the small intestine, 65 of 272 (24%) of the large intestine and 128 of 272 (47%) reported both. Seventy-two studies (26.4%) focused on single complications. No study explicitly defined the term complication or cited a classification of complications. One study reported the definitions of 'sequela', 'progression' or 'recurrence' of lesions. Eighty-one postoperative complications were reported in two-time frames defined as short- and long-term. The definitions of most complications and long-term follow-ups were highly variable.

Main Limitation: Non-English language studies or conference proceedings were excluded.

Conclusion: There was a substantial lack of classifications of postoperative complications. The definitions of complications were highly variable, making it difficult to compare studies. Adopting classification systems and definitions may help surgeons to obtain a complete picture of the efficacy of a procedure or treatment and allow comparisons between studies, centres or time periods.