Mitomycin C: an alternative conservative treatment for refractory esophageal stricture in children?
| Autor: | Laurent Michaud, Frédéric Gottrand, F Vachin, S. Uhlen, Pierre Fayoux, Dominique Turck, D. Guimber |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Administration Topical Mitomycin Anastomosis medicine Humans Prospective cohort study Child Retrospective Studies Antibiotics Antineoplastic Esophageal disease business.industry Mitomycin C Gastroenterology Infant Retrospective cohort study medicine.disease Dysphagia Dilatation Surgery Radiography Treatment Outcome Dysplasia Child Preschool Esophageal stricture Esophageal Stenosis Female Esophagoscopy medicine.symptom business Follow-Up Studies |
| Zdroj: | Endoscopy. 38(4) |
| ISSN: | 0013-726X |
| Popis: | Background and study aims Mitomycin C is an antiproliferative agent that has been used successfully as an adjunct treatment in ophthalmological procedures, in the management of laryngeal and tracheal stenosis, and more recently to prevent the recurrence of caustic esophageal strictures in children. The aim of this study was to assess the efficacy and safety of local application of mitomycin C to refractory esophageal strictures in children. Patients and methods We performed a preliminary prospective study of local application of mitomycin C in four children, aged between 1 year and 6 years, who had refractory esophageal strictures. Two of the children presented with strictures caused by caustic ingestion and the other two children had anastomotic strictures following surgical repair of congenital esophageal atresia. The patients had required between four and ten esophageal dilations over a 5-24-month period before mitomycin C application. After an endoscopic dilation, mitomycin C was applied onto the dilation wound using a rigid endoscope. Results No complications were observed after the procedure. One child required a second application of mitomycin C 2 weeks after the first application because of recurrence of dysphagia. All the children remained asymptomatic and none of them required further dilation over a mean follow-up period of 24 months. Radiological control examinations revealed that there was no recurrence of the esophageal strictures and esophageal biopsies performed during follow-up showed no signs of dysplasia. Conclusions Local application of mitomycin C is a potential alternative to iterative dilations, surgery, or stent placement for the treatment of refractory esophageal strictures in children. However, prospective, long-term assessment of outcomes is needed before any definitive conclusion can be drawn about the usefulness of mitomycin C in these patients. |
| Databáze: | OpenAIRE |
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