Topical Application of Mitomycin‐C in Oesophageal Strictures

Abstract

Postdilation application of topical mitomycin-C resulted in major success in 62.5% of patients and partial success in 19%, and it may be a useful strategy in oesophageal strictures of differing causes that are refractory to repeated perendoscopic dilation.

Topical mitomycin-C for recalcitrant esophageal strictures: a novel endoscopic/fluoroscopic technique for safe endoluminal delivery

“…Recently, the antifibroblast chemotherapy drug mitomycin-C has been shown to have some efficacy in reducing stricture recurrence after its topical application immediately after pneumatic dilation or esophageal bougienage [7][8][9][10][11][12]. In these reports, mitomycin-C was delivered and applied to the dilated stricture site endoscopically, without comment on the potential for inadvertent application to other areas of the upper aerodigestive tract (mouth, pharynx, uninvolved esophagus, stomach).…”

Topical mitomycin-C for the treatment of anal stricture

“…Furthermore, the application of topical mitomycin-C also has been well studied in both animals [21] and humans [9,10] with laryngotracheal stenoses, albeit with varying degrees of success [11]. More recently, topical mitomycin-C has been shown to improve esophageal strictures refractory to repeated intraluminal dilatations [12][13][14][15]. Finally, there is anecdotal evidence of its positive effects in the treatment of both urethral [16] and vaginal [17] strictures.…”

“…Mitomycin-C, a chemotherapeutic agent that is known to inhibit RNA and protein synthesis, has been shown to be particularly effective in the prevention of fibroblast proliferation that can lead to scarring [7]. It has been used topically to treat stricture at a variety of anatomical locations including the eye [8], the upper airway [9][10][11], the esophagus [12][13][14][15], the urethra [16], and the vagina [17]. However, there is no documented evidence of its use for anorectal stricture.…”

Esophageal Stents for Severe Strictures in Young Children: Experience, Benefits, and Risk

“…Covered esophageal stents in children offer endoscopists an additional tool in our arsenal for treatment of these challenging patients. A recent multicenter study examining the use of mitomycin C for refractory esophageal strictures suggests that this may be another important tool in this population [16]. Additional prospective studies are needed to define patients better suited to one or another of these treatment modalities, or to develop a treatment algorithm encompassing both.…”