Pelvic Flexure Enterotomy in Horses: Scoping Review and Synthesis of the Literature (1996-2026)

This scoping review maps the available literature aimed at identifying the most appropriate technique for suturing pelvic flexure enterotomies in horses. A comprehensive search of Web of Science, Google Scholar, and the National Center for Biotechnology Information was conducted for studies published between January 1996 and February 2026, using terms related to pelvic flexure enterotomy and equine patients. From 22,146 records, only five ex vivo studies on healthy equine colon specimens met the inclusion criteria. The studies compared variables such as suturing time, suture pattern, material, bursting pressure, luminal diameter reduction, and cost. Double-layer hand-sewn closure generally achieved the highest bursting pressures, although it required longer operative time, while TA90 stapling was the most expensive option. Because ex vivo models cannot reproduce tissue healing or host-construct interactions, the clinical applicability of the available evidence remains limited. Nonetheless, a full-thickness simple continuous pattern oversewn with a continuous Cushing pattern appears to offer the most dependable mechanical security until stronger in vivo evidence becomes available.