Esophageal healing in the pony: comparison of sutured vs nonsutured esophagotomy

Esophageal healing was evaluated in 10 ponies after sutured and nonsutured cervical esophagotomy techniques. Mucosal healing occurred significantly (P less than 0.005) faster after sutured esophagotomies (x = 7.5 days after surgery) than after nonsutured esophagotomies (x = 25.6 days after surgery), based on endoscopic and clinical evaluations. Although endoscopy was an accurate assessment of the return of normal passage of a food bolus through the esophagus, 4 of 10 ponies had radiographic evidence of a sinus tract after the mucosa was considered healed, based on endoscopic and clinical examinations. The surgical skin wound also healed significantly sooner after sutured esophagotomies (x = 10 days) than after nonsutured esophagotomies (x = 33.4 days). A traction diverticulum developed in all ponies with nonsutured esophagotomies, but occurred in only 1 pony with sutured esophagotomy. Minor complications were seen more frequently with sutured esophagotomy than with a nonsutured esophagotomy, but were resolved with local therapy. Saliva appeared to inhibit wound healing. All ponies were fed through esophagostomy tubes until the mucosa at the esophagotomy site was considered healed. Except for 1 sutured esophagotomy that dehisced, sutured esophagotomy was superior to nonsutured esophagotomy, because earlier establishment of a mucosal seal resulted in more rapid healing and reduced nursing care.