Comparison of three feeding techniques after esophageal mucosal resection and anastomosis in the horse.

Abstract

The effects of 3 feeding techniques on healing of a cervical esophageal mucosal resection and anastomosis were investigated in 16 horses. Horses were fed a moistened pelleted diet 1 of 3 ways: 1) per os (n = 5), 2) by nasogastric (n = 5) or 3) by esophagostomy tube (n = 6) until the 14th postoperative day. The pelleted diet was then fed orally in all horses until euthanasia on the 60th postoperative day. Immediate postoperative feeding per os was unsatisfactory, as only 2 of 5 horses survived in this group. Endoscopic evaluation revealed that mucosal dehiscence of varying degrees occurred, with subsequent stricture formation in all horses. Although the incidence of some complications (fistula, sinus tract and traction diverticulum) was higher in the nasogastric tube-fed horses, 2 of 6 horses in the esophagostomy tube-fed group did not survive to the end of the study. There was more cervical phlegmon in the esophagostomy tube-fed group, and this resulted in increased periesophageal fibrosis on histopathologic examination. Radiographic measurements showed that esophageal lumen diameter increased predominantly between 30 and 45 days postoperatively. The mucosal healing time was significantly faster (p = 0.05) in the esophagostomy tube-fed group.