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Topical mitomycin C application is effective in management of localized caustic esophageal stricture: a double-blinded, randomized, placebo-controlled trial.

AbstractBACKGROUND:
Frequent sessions of endoscopic dilatation are usually required in the management of benign esophageal strictures, especially caustic induced ones. Topical mitomycin C (MMC) has been recently used in the management of resistant strictures. This study evaluated the efficacy of MMC application in prevention of stricture recurrence after endoscopic dilatation.
PATIENTS AND METHODS:
This double-blind, randomized, placebo-controlled trial included forty patients with caustic esophageal strictures dating from January 2008 to October 2010. Patients were randomized into 2 groups to undergo endoscopic dilatation with application of either MMC versus placebo on stricture site. Regular follow up and re-evaluation were done after 6 months of management. The number of dilatation sessions needed for resolution of dysphagia in each group was our primary outcome.
RESULTS:
During the specified follow up period, 80 % of strictures in the MMC group got completely resolved compared to only 35% in the placebo group. The mean number of dilatation sessions needed in the MMC group was n = 3.85 ± 2.08 compared to n = 6.9 ± 2.12 in the placebo group which was statistically significant (p < 0.001).
CONCLUSION:
Mitomycin C application significantly reduced the number of dilatation sessions needed to alleviate dysphagia in patients with caustic esophageal strictures.
AuthorsKhaled M El-Asmar, Mohamed A Hassan, Hesham M Abdelkader, Alaa F Hamza
JournalJournal of pediatric surgery (J Pediatr Surg) Vol. 48 Issue 7 Pg. 1621-7 (Jul 2013) ISSN: 1531-5037 [Electronic] United States
PMID23895984 (Publication Type: Journal Article, Randomized Controlled Trial)
CopyrightCopyright © 2013 Elsevier Inc. All rights reserved.
Chemical References
  • Caustics
  • Mitomycin
Topics
  • Administration, Topical
  • Burns, Chemical (drug therapy)
  • Caustics (toxicity)
  • Child, Preschool
  • Double-Blind Method
  • Esophageal Stenosis (chemically induced, drug therapy)
  • Female
  • Humans
  • Male
  • Mitomycin (administration & dosage)
  • Prospective Studies

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