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

This research investigated different feeding methods after esophageal surgery in horses, comparing their effects on recovery and survival rates. The study found that feeding via an esophagostomy tube facilitated the fastest mucosal healing, though it showed some complications including increased fibrosis and mortality.

Research Design and Methods

• This study involved 16 horses divided into three groups, each utilizing a different feeding technique after undergoing esophageal mucosal resection and anastomosis.
• The horses were fed a moistened pelleted diet after surgery in one of the following ways: per os (orally; with 5 horses), nasogastric tube (5 horses), and esophagostomy tube (6 horses).
• The diet was administered in these manners until the 14th postoperative day. After this, the diet was given orally to all horses until they were euthanized for examination on the 60th postoperative day.

Key Findings

• The study showed unsatisfactory results with immediate postoperative oral feeding, as only 2 of the 5 horses in this group survived.
• The endoscopic evaluation revealed that all horses experienced mucosal dehiscence of various degrees, leading to stricture formation.
• Even though the nasogastric tube-fed horses exhibited higher incidences of complications like fistula, sinus tract, and traction diverticulum, 2 out of 6 horses in the esophagostomy tube-fed group did not survive to the end of the study.
• The esophagostomy tube-fed group had more cases of cervical phlegmon, leading to an increase in periesophageal fibrosis upon histopathologic examination.
• Radiographic measurements showed that the esophageal lumen diameter predominantly increased between the 30 and 45 days postoperatively.
• The fastest mucosal healing time was significantly seen (p = 0.05) in the esophagostomy tube-fed group.

Implications and Significance

• These findings suggest that in the aftermath of esophageal surgery, feeding horses via an esophagostomy tube may facilitate the quickest mucosal healing. Although this method did come with some complications, like higher fibrosis and a lower survival rate, the overall healing was faster.
• The study contributes important insights to best practices for postoperative care in horses, particularly in relation to the feeding technique adopted.
• It is vital to conduct further research focusing on ways to decrease associated complications while speeding up healing, to give horses a better chance of recovery from esophageal surgeries.