Abstract | OBJECTIVE: METHODS: A prospective, randomized, double-blind, controlled study was carried out. End-to-end anastomosis was performed in 18 rabbits after tracheal annulus resection to produce inflammation. There were 3 treatment groups: topical saline (isotonic sodium chloride solution) and low-dose (0.2 mg/mL) and high-dose (0.5 mg/mL) topical mitomycin. RESULTS: A total of 107 procedures were performed: 54 surgical procedures, 35 fibrobronchoscopies, and 18 biopsies. The effect of mitomycin was dose related. In the high-dose mitomycin group, most rabbits progressed to stenosis with a percentage decrease in airway diameter that was significantly greater than in the other 2 groups (P <.001). The mean (SD) percentage of maximum stenosis in the high-dose group was 51% (22%). In the low-dose and saline groups, it was 18% (13%) and 16% (9%), respectively. No significant differences in tracheal stenosis between the low-dose mitomycin and saline groups were observed. Blinded histopathological analysis also showed no significant differences between the saline group and the low-dose mitomycin group. Compared with the other 2 groups, the high-dose mitomycin group had a significant increase in fibroproliferative tissue (P <.001). CONCLUSION: These results suggest that topical mitomycin is not effective for avoiding tracheal stenosis and may provoke the opposite effect if the dose is not carefully selected.
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Authors | Rodrigo Iñiguez-Cuadra, José San Martín Prieto, Magaly Iñiguez-Cuadra, Sergio Zúñiga Erranz, David Jofré Pavez, Sergio González Bombardiere, J M Guilemany Toste, Rodrigo Iñiguez-Sasso |
Journal | Archives of otolaryngology--head & neck surgery
(Arch Otolaryngol Head Neck Surg)
Vol. 134
Issue 7
Pg. 709-14
(Jul 2008)
ISSN: 1538-361X [Electronic] United States |
PMID | 18645119
(Publication Type: Journal Article)
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Chemical References |
- Antimitotic Agents
- Mitomycin
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Topics |
- Airway Obstruction
(pathology, prevention & control)
- Anastomosis, Surgical
- Animals
- Antimitotic Agents
(pharmacology)
- Biopsy
- Bronchoscopy
- Disease Models, Animal
- Dose-Response Relationship, Drug
- Laryngoscopy
- Laryngostenosis
(pathology, prevention & control)
- Larynx
(pathology, surgery)
- Mitomycin
(pharmacology)
- Postoperative Complications
(pathology, prevention & control)
- Prospective Studies
- Rabbits
- Trachea
(pathology, surgery)
- Tracheal Stenosis
(pathology, prevention & control)
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