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Topical Mitomycin-C Application in Recurrent Esophageal Strictures After Surgical Repair of Esophageal Atresia

Chapuy, Laurence; Pomerleau, Martine; Faure, Christophe

Journal of Pediatric Gastroenterology & Nutrition: November 2014 - Volume 59 - Issue 5 - p 608–611
doi: 10.1097/MPG.0000000000000352
Original Articles: Gastroenterology

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.

Division of Pediatric Gastroenterology, Sainte-Justine University Hospital Center, Montreal, QC, Canada.

Address correspondence and reprint requests to Laurence Chapuy, MD, Division of Pediatric Gastroenterology, CHU Sainte-Justine, 3175, Chemin de la Côte-Sainte-Catherine Montreal, Quebec, H3T 1C5 (e-mail: laurence.chapuy@gmail.com).

Received 27 June, 2013

Accepted 21 February, 2014

The authors report no conflicts of interest.

© 2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,