Topical mitomycin C application is effective in management of localized caustic esophageal stricture: A double-blinded, randomized, placebo-controlled trial

Abstract Background Frequent sessions of endoscopic dilatation are usually required in the management of benign esophageal strictures, especially caustic induced ones. Topical mitomycin C (MMC) has been recently used in the management of resistant strictures. This study evaluated the efficacy of MMC...

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Bibliographic Details
Published in:Journal of pediatric surgery 2013-07, Vol.48 (7), p.1621-1627
Main Authors: El-Asmar, Khaled M, Hassan, Mohamed A, Abdelkader, Hesham M, Hamza, Alaa F
Format: Article
Language:English
Subjects:
Administration, Topical
Burns, Chemical - drug therapy
Caustic esophageal stricture
Caustics - toxicity
Child, Preschool
Double-Blind Method
Endoscopic dilatation
Esophageal Stenosis - chemically induced
Esophageal Stenosis - drug therapy
Female
Humans
Male
Mitomycin - administration & dosage
Mitomycin C
Pediatrics
Prospective Studies
Surgery
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Summary:Abstract Background Frequent sessions of endoscopic dilatation are usually required in the management of benign esophageal strictures, especially caustic induced ones. Topical mitomycin C (MMC) has been recently used in the management of resistant strictures. This study evaluated the efficacy of MMC application in prevention of stricture recurrence after endoscopic dilatation. Patients and methods This double-blind, randomized, placebo-controlled trial included forty patients with caustic esophageal strictures dating from January 2008 to October 2010. Patients were randomized into 2 groups to undergo endoscopic dilatation with application of either MMC versus placebo on stricture site. Regular follow up and re-evaluation were done after 6 months of management. The number of dilatation sessions needed for resolution of dysphagia in each group was our primary outcome. Results During the specified follow up period, 80 % of strictures in the MMC group got completely resolved compared to only 35% in the placebo group. The mean number of dilatation sessions needed in the MMC group was n = 3.85 ± 2.08 compared to n = 6.9 ± 2.12 in the placebo group which was statistically significant (p < 0.001). Conclusion Mitomycin C application significantly reduced the number of dilatation sessions needed to alleviate dysphagia in patients with caustic esophageal strictures.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2013.04.014