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Topical Application of Mitomycin-C in Oesophageal Strictures
- Source :
- Journal of Pediatric Gastroenterology & Nutrition. 44:336-341
- Publication Year :
- 2007
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2007.
-
Abstract
- Benign oesophageal strictures may occur as a complication of caustic ingestion or severe gastro-oesophageal reflux or as a sequela of oesophageal surgery and other fibrosing conditions. The traditional initial treatment of oesophageal strictures is intraluminal dilation; however, even if frequent, this occasionally may not provide adequate oesophageal lumen capacity or give significant symptom-free intervals, and restricturing after dilation is difficult and challenging. Topical postdilation application of an antifibrotic agent, mitomycin-C, in the treatment of an oesophageal stricture has been described.Eight centres participated, with a total of 16 patients (4 girls), median age 48 (range 0-276) months. The causes of stricture were as follows: caustic (10), post-trachea-oesophageal fistula repair (2), peptic (2), Crohn disease (1), and dystrophic epidermolysis bullosa (1). The median (range) length and diameter of the strictures were as follows: 22 mm (8-50 mm) and 1.5 mm (1-6 mm). Of the 16 patients, 15 had undergone repeated dilations varying from 3 to more than 1000 (daily self-bouginage) before mitomycin-C, and the median interval between dilations was 4 weeks. Mitomycin-C 0.1 mg/mL was applied after dilation for a median time of 3.5 minutes and a median of 3 (1-12) times.Major success, both endoscopic and clinical improvement or cure, occurred in 10 of 16 patients. In 3 of 16 patients the interval period between dilations increased dramatically. Failure of therapy was considered in 3 of 16. All of the patients remained symptom free for a follow-up time of as long as 5 years.Postdilation application of topical mitomycin-C resulted in major success in 62.5% of patients and partial success in 19%, and it may be a useful strategy in oesophageal strictures of differing causes that are refractory to repeated perendoscopic dilation.
- Subjects :
- Male
medicine.medical_specialty
Administration, Topical
Mitomycin
Anti-Inflammatory Agents
Gastroenterology
Oesophageal surgery
Internal medicine
medicine
Humans
Initial treatment
Caustic ingestion
business.industry
Esophageal disease
digestive, oral, and skin physiology
Mitomycin C
Infant, Newborn
Reflux
Infant
Sequela
medicine.disease
Dilatation
digestive system diseases
Surgery
Child, Preschool
Pediatrics, Perinatology and Child Health
Esophageal Stenosis
Female
Esophagoscopy
Complication
business
Subjects
Details
- ISSN :
- 02772116
- Volume :
- 44
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric Gastroenterology & Nutrition
- Accession number :
- edsair.doi.dedup.....ef6874cacbb1b91273fb42e17c87fe5b