Open AccessTopical Mitomycin‐C Application in Recurrent Esophageal Strictures After Surgical Repair of Esophageal Atresia
Author(s) -
Chapuy Laurence,
Pomerleau Martine,
Faure Christophe
Publication year - 2014
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0000000000000352
Subject(s) - medicine , mitomycin c , atresia , anastomosis , surgery , stenosis , esophageal stricture , endoscopy , medical record , retrospective cohort study , dysplasia , cohort , esophagus
Objectives: The aim of the present study was to evaluate the efficacy and short‐term safety of topical mitomycin‐C, an antifibrotic agent, in preventing the recurrence of anastomotic strictures after surgical repair of esophageal atresia (EA). Methods: We retrospectively reviewed the medical records of patients with recurrent anastomotic strictures after EA surgery who underwent at least 3 esophageal dilations. We compared the outcome (ie, resolution of the stricture) of the group that received topical mitomycin‐C treatment with endoscopic esophageal dilation with a historical cohort treated by dilations alone. Results: A total of 11 children received mitomycin‐C concurrently with endoscopic dilations. After a median follow‐up of 33 months (range 18–72), and a mean number of 5.4 dilations per patient (range 3–11), 8 of 11 patients achieved a resolution of their strictures, 2 patients remained with stenosis, and 1 patient needed a surgical correction. In the control group, 10 patients required an average of 3.7 (range 3–7) total dilations. After a follow‐up of 125 months (range 35–266) after the last dilation, strictures in 9 of 10 children disappeared and the remaining patient was symptom free. No dysplasia related to mitomycin‐C was demonstrated. Conclusions: There is no benefit in the resolution of the stricture when adding mitomycin‐C treatment compared with repeated esophageal dilations alone in historical controls. Further randomized controlled studies and a short‐ and long‐term evaluation of safety are needed.