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Short-term Effects of Mitomycin C Infiltration for Caustic Oesophageal Strictures in Children

Wishahy, Ahmed M.K.*; Seleim, Hamed; Qinawy, Mohamad*; Mohamed, Wesam*; Mansour, Omar*; Abdullateef, Khaled S.*; Elkadi, Reda; Raslan, Heba; Arafa, Ahmed*; Yassin, Tamer

Journal of Pediatric Gastroenterology and Nutrition: December 2019 - Volume 69 - Issue 6 - p 673–677
doi: 10.1097/MPG.0000000000002466
Clinical Trials: Gastroenterology

Objectives: The aim of this study was to investigate the efficacy and safety of endoscopic local infiltration of mitomycin C (MMC) after oesophageal dilation for children suffering from refractory postcorrosive oesophageal stricture (OS).

Methods: Children referred to Cairo University Specialized Paediatric Hospital with refractory postcorrosive OS during the period from March 2016 to August 2017 were included in this study. MMC was infiltrated endoscopically at the stricture site by the end of the dilation session. The measured outcomes were dysphagia score (DS) and periodic dilation index (PDI).

Results: During the inclusion period of the presented study, 17 children met the inclusion criteria. There were 7 boys and 10 girls. During the follow-up period, an average of 3.8 dilation sessions with MMC infiltration per case were performed, using a total dose of 1 mg each session. The median follow-up period was 9.5 months. The median DS improved from DS 3 before application of MMC to DS 0 at the last follow-up (P < 0.001). Additionally, the median PDI declined from 1 to 0.75 after MMC application (P = 0.052). Sixteen cases (94%) became dysphagia free after 6 months. Seven patients experienced postdilation minor bleeding that was spontaneously resolved, not triggering blood transfusion. There were no infiltration-related complications in the included series.

Conclusion: Stricture-site MMC endoscopic infiltration by the end of a dilation session proved to be safe and effective in improving the DS and PDI.

*Department of Paediatric Surgery, Cairo University Specialized Paediatric Hospital, Cairo

Department of Paediatric Surgery, Tanta University Hospital, Tanta

Department of Paediatrics, Cairo University Specialized Paediatric Hospital, Cairo, Egypt.

Address correspondence and reprint requests to Ahmed M.K. Wishahy, Faculty of Medicine, Cairo University, Kasr Alainy, Giza, Dokkie, Egypt (e-mail:

Received 24 February, 2019

Accepted 3 August, 2019

The authors report no conflicts of interest.

© 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,