Topical application of mitomycin-C as an adjuvant treatment to bronchoscopic procedures in post-intubation tracheal stenosis.

Abstract

INTRODUCTION:

Post-intubation tracheal stenosis (PITS) continues to be challenging in terms of diagnosis, management and prevention. Recurrence is common because of excessive granulation tissue formation and an insidious process of scar contracture. Topical application of mitomycin-C (MMC) as an adjuvant treatment for endoscopic management of stenosis has shown good results. The authors aimed to evaluate the results of MMC topical application following bronchoscopic dilatation as an adjuvant in PITS treatment.

METHODS:

Retrospectively selected patients with PITS who had had rigid bronchoscopy (RB) dilatation followed by MMC application as adjuvant to endoscopic treatment. MMC in a concentration of 0.4 mg/ml was applied with a cotton stiletto around the stenotic lesion and granulation tissue for 3 minutes.

RESULTS:

Eleven patients with PITS, with a median initial tracheal stenosis of 75% of the lumen, underwent RB/MMC treatment. Mean MMC sessions performed/patient was 3.5, with good response and prolonged decrease in granulation tissue formation in 55% of cases, moderate in 18% and relapse in 27%. Mean stenosis improvement was 34%.

CONCLUSIONS:

Topical MMC application at 0.4 mg/ml concentration seems to be associated with good results as adjuvant in PITS management with decrease in granulation tissue and sustained improvement in lumen diameter.

• Authors: F Viveiros, J Gomes, A Oliveira, S Neves, J Almeida, J Moura e Sá
• Journal: Revista portuguesa de pneumologia (Rev Port Pneumol) 2013 Nov-Dec Vol. 19 Issue 6 Pg. 276-80 ISSN: 2172-6825 [Electronic] Spain
• PMID: 24119923 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

Chemical References

• Mitomycin

Topics

• Administration, Topical
• Adult
• Aged
• Bronchoscopy
• Chemotherapy, Adjuvant
• Female
• Humans
• Intubation, Intratracheal (adverse effects)
• Male
• Middle Aged
• Mitomycin (administration & dosage)
• Retrospective Studies
• Tracheal Stenosis (etiology, therapy)