Tracheal reconstruction by resection and end-to-end anastomosis in the horse.

A surgical technique for resection of a portion of the trachea followed by end-to-end anastomosis was developed on 4 clinically normal horses. The trachea healed without complications in 3 of the horses in which 3 tracheal cartilages were removed. Five tracheal cartilages were removed from the 4th horse. It had to be euthanatized because of excessive suture line tension and wound disruption, which occurred during recovery from anesthesia. Suture line tension was measured on 3 other clinically normal horses positioned in dorsal recumbency immediately after euthanasia after 3 and 5 tracheal cartilages had been removed and before and after flexion of the neck to 90 degrees. Suture line tension was reduced by approximately 50% when the neck was flexed. Similarly, the force required to appose the cut ends of the trachea was nearly doubled when 5 rather than 3 tracheal cartilages were removed. The surgical technique was performed on 1 horse and 1 pony with partial obstruction of the trachea. In the pony, 5 tracheal cartilages were resected. It was able to return to successful show competition. In the horse, 4 tracheal cartilages were removed. This horse died of complications resulting from bilateral hindlimb myositis, but the tracheal anastomosis was intact, sealed, and healing well.