Efficacy and Safety of the Local Application of Mitomycin C to Recurrent Esophageal Strictures in Children
The authors report no conflicts of interest.
ABSTRACT
Objectives:
Research on long-term use of mitomycin C (MC) for recurrent esophageal stenoses is limited. We assessed the long-term efficacy and safety of local application of MC for recurrent esophageal stenoses in children.
Methods:
This was a retrospective study of 39 patients (17 girls) with a median age of 19.5 months (range: 2.4–196.0) at the time of MC application. The etiologies of stenosis were esophageal atresia (n = 25), caustic ingestion (n = 9), congenital esophageal stenosis (n = 3), and other causes (n = 2). Stenosis was single in 35 (90%) patients and multiple in 4 (10%). Before MC, patients underwent multiple repeated dilations (median: 3 dilations per child [range: 2–26]) over a median period of 7 months (range: 2.6–49.3). Treatment success was defined a priori as a reduction in the number of dilations over the same period from before to after the application of MC.
Results:
For 26 (67%) patients, the application of MC was considered a success: 102 versus 17 dilatations (P < 0.0001). Sixteen (41%) patients never required additional dilation during the follow-up after MC application (median: 3.1 years [range: 0.6–8.5]). No complication related to MC was observed. Biopsies at the site of MC application were performed at maximal follow-up in 16 patients and revealed no dysplasia. Three factors were associated with success of MC: single stenosis, short stenosis, and esophageal atresia type III.
Conclusions:
This study is the largest series reported showing that topical application of MC is an efficient and safe treatment for recurrent esophageal stenosis in children.
