Short Term Effects of Mitomycin C Infiltration for Caustic Oesophageal Strictures in Children.

Abstract

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 post-corrosive oesophageal stricture (OS). METHODS Children referred to Cairo University Specialized Paediatric Hospital with refractory post-corrosive 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, seventeen children met the inclusion criteria. There were seven males and ten females. 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 six months. Seven patients experienced post-dilation 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.