Open AccessEfficacy and Safety of the Local Application of Mitomycin C to Recurrent Esophageal Strictures in Children
Author(s) -
Ley Delphine,
Bridenne Marie,
Gottrand Frédéric,
Lemale Julie,
Hauser Bruno,
Lachaux Alain,
Rebouissoux Laurent,
Viala Jérôme,
Fayoux Pierre,
Michaud Laurent
Publication year - 2019
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.0000000000002445
Subject(s) - medicine , stenosis , atresia , mitomycin c , complication , esophageal stricture , retrospective cohort study , surgery , dysplasia , esophagus , gastroenterology
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.