Table 1.

Details of the procedure in available literature.

Publication (chronologically)	Marsupialization approach	Marsupialization technique details	Animals	Perioperative management	Outcome	Complications	Miscellaneous
Trent and Smith (10)	Right paramedian translocation	Marsupialization: 4 cm long incision 1–2 cm right paramedian and 5 cm caudal to xiphoid Stump attachment: 3 layers of SIRa sutures incorporating the fibrous vein stalk to all layers of the abdominal wall	3 calves	Daily stump flushing with 10% iodine while drainage persisted. Antibiotics extended beyond 24 h postop	2 animals good or fair (drainage from the stump ceased after 12d in one calf and after 23 d in the other)	1 animal euthanized during the surgery due to excessive liver abscessation
Steiner et al. (2)	Cranial midline translocation	Marsupialization: laparotomy incision extended to 3 cm caudal to the xiphoid, Stump attachment: vein stalk implemented in its cranial aspect with 2 rows of SIR sutures (synthetic absorbable monofilament) Other: Remainder of the celiotomy closed in 3 layers of simple continuous pattern, skin edges apposed with staples	13 calves	Daily stump flushing with 0.1% povidone (pressurized: 8 calves; non-pressurized: 5) until lavage fluid was clear for ≥3 d. Antibiotics for 3 d postop	Fair in 9 animals (8 used in breeding), poor in 2 and 2 were euthanized; based on weight gain over time in comparison to healthy calves	Stump flushing transitioned from pressurized to non-pressurized due to adverse reactions. Hernia at the marsupialization site developed in 9 animals; corrected in 8 during a second surgery; all those animals were intended for breeding	Adverse reactions to pressurized stump flushing were associated with younger age and disease severity; none occurred with non-pressurized flushing. Eight breeding-intended animals underwent corrective surgery of the marsupialization site hernia
Edwards and Fubini (11)	Right paramedian translocation	Stump attachment: 3 layers- external rectus sheath and subcutis were apposed to connective tissue of the vein wall, (synthetic absorbable monofilament 2/0 USP), skin was sutured to the wall with nonabsorbable material to be removed 14 d later, all layers closure- SIR	5 calves and 2 foals	Vein flushed with 10% povidone; venous drains placed in 2 calves; daily flushing until healed. No flushing in 1 calf and both foals due to friable veins. Antibiotics for 7–28 d	Good in all patients, some limitations of long-term survival were unrelated to the omphalophlebitis	2 calves developed cellulitis 14 d postop at marsupialization site, which resolved with repeated antibiotic therapy	Vein stump clamped as it traversed the body wall at the marsupialization site; no major breaches of sterility reported
Marchionatti et al. (14)	Right paramedian translocation	Marsupialization: incision linear/circular fitting size of the translocated vein, musle of abdominal wall disected with Metzenbaum scissors, peritoneum opened with a scalpel blade Stump attachment: one/2 layer with modified interrupted horizontal mattress (2/0–1 USP synthetic monofilament suture) incorporating the wall of the vein to the skin	20 calves (1 calf underwent cranial translocation)	In 7 calves, the stump was flushed postoperatively using a small catheter to minimize intravascular pressure Antibiotics continued ≥72 h postoperatively, extended as needed	Considered good with 74% animals performing well long term	Hernia at the marsupialization site in 6/15 calves (46%); most were small. Revision was straightforward in 4 cases; a fifth calf had a 20 cm hernia that healed by first intention without mesh. Cellulitis at the marsupialization site occurred in 13% of calves	Stump sutured and protected in a sterile glove before passage through the paramedian incision. Stump resection in the standing animal left ≤1 cm ventral to the abdominal wall, typically at 24–48 h postoperatively (range: immediate–72 h postop)
	Cranial midline translocation		1 calf			Small abdominal hernia- at the marsupialization site, not requiring surgery
Codina et al. (8)	Cranial midline translocation	As described by Steiner et al. (see above)	2 foals		One foal developed adhesions of the operated area and jejunum, required resection and anastomosis, euthanized due to septic peritonitis		An additional foal was euthanized for severe colic; post-mortem revealed extensive hepatic infection. This foal did not undergo umbilical vein marsupialization
Klein et al. (15)	Right paramedian translocation	Marsupialization: 6 cm incision was used for marsupialization Stump attachment: 1 layer SIR, USP 2/0, synthetic monofilament material	5 foals	Stump lavage twice daily with diluted chlorhexidine during hospitalization. Antibiotics continued ≥72 h postop		3 foals developed hernia at the marsupialization site
Obrochta et al. (13)	Right paramedian translocation	Marsupialization: 2–3 cm long right paramedian incision Stump attachment: 2 layers of SIR sutures (USP 2/0, synthetic monofilament material), vein wall to rectus sheath and vein wall to the skin	9 foals (11 foals included in the study)	Stomata cleaned superficially with 1% povidone or saline; gentle saline flush of the stump then filled with polymer hydrogel; Sutures/staples removed at 14 d Antibiotics ≥7 d postoperatively, extended as indicated Stall rest 14 d, then 6 w small paddock turnout	10/11 foals omphalophlebitis resolved and were available for long term follow up	Short-term complications: comorbidities (pneumonia/septic arthritis) in 4 foals; one euthanized 6 d after initial surgery. Other: postoperative myopathy and stoma necrosis in 1 foal. Long-term complications: hernia at the stoma site in 2 foals; hernia at the celiotomy incision in 1 foal. Colic in 1 foal	Vein ligated near the umbilicus before transection; after marsupialization, stumps were respected to within a few millimeters ventral to the abdominal wall
	Cranial midline translocation	Marsupialization: laparotomy incision extended craniad Stump attachment: vein stalk implemented in its cranial aspect with 2 rows of SIR sutures (synthetic absorbable monofilament). Other: Remainder of the celiotomy closed in 3 layers of simple continuous pattern, skin edges apposed with staples or SIR (synthetic absorbable suture)	2 foals (11 foals included in the study)			Foal 1: Hernia at caudal incision; alive at 88 m. follow-up Foal 2: Colic 4 m. postoperatively; hernia at stoma site; alive at 88 m. follow-up

^aSIR, simple interrupted suture pattern.