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

Ahmed M K Wishahy1, Hamed Seleim2, Mohamad Qinawy1

  • 1Department of Paediatric Surgery, Cairo University Specialized Paediatric Hospital, Cairo.

Journal of Pediatric Gastroenterology and Nutrition
|August 23, 2019
PubMed

Insights

Endoscopic local infiltration of mitomycin C (MMC) effectively treats refractory postcorrosive esophageal strictures in children. This safe treatment significantly reduces dysphagia and improves dilation outcomes.

Area of Science:

  • Pediatric Gastroenterology
  • Endoscopic Therapeutics
  • Otolaryngology

Background:

  • Refractory postcorrosive esophageal strictures (OS) pose a significant challenge in pediatric care.
  • Conventional treatments like dilation often require multiple sessions and may have limited long-term success.

Purpose of the Study:

  • To evaluate the efficacy and safety of endoscopic local infiltration of mitomycin C (MMC) in children with refractory OS.
  • To assess the impact of MMC on dysphagia score (DS) and periodic dilation index (PDI).

Main Methods:

  • A prospective study included 17 children with refractory postcorrosive OS.
  • Mitomycin C (MMC) was endoscopically infiltrated at the stricture site post-dilation.
  • Dysphagia score (DS) and periodic dilation index (PDI) were the primary outcome measures.

Main Results:

  • Median DS improved from 3 to 0 (P < 0.001), with 94% of patients becoming dysphagia-free at 6 months.
  • Median PDI decreased from 1 to 0.75 (P = 0.052).
  • Minor postdilation bleeding occurred in 7 patients, resolving spontaneously without transfusion; no infiltration-related complications were noted.

Conclusions:

  • Endoscopic MMC infiltration is a safe and effective adjunct to esophageal dilation for pediatric refractory OS.
  • This technique significantly improves swallowing function and reduces the need for repeated dilations.
Abstract

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