Endoscopic Injection of Mitomycin C for the Treatment of Pharyngoesophageal Stenosis Refractory to Endoscopic Treatment with Dilatation in Patients Treated for Head and Neck Cancer

Gusmon-Oliveira, Carla Cristina; Kuboki, Yeda; Paulo, Gustavo Andrade de; Lima, Marcelo Simas de; Uemura, Ricardo S.; Martins, Bruno Costa; Tolentino, Luciano Lenz; Safatle‐Ribeiro, Adriana Vaz; Kulcsar, Marco Aurélio Vamondes; Ribeiro, Ulysses; Maluf‐Filho, Fauze

doi:10.1155/2018/5428157

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…Gusmon-Oliveira et al [15] concluded that the repeated injection in the short interval of MMC in refractory pharyngoesophageal stenosis in patients after head and neck cancer is not recommended, this finding was in great difference with our results, this can be easily explained by different age group and different nature of both diseases.…”

Section: Discussioncontrasting

confidence: 97%

Endoscopic postdilatation application of Mitomycin C in children with resistant esophageal strictures

Rashed

El‐Guindi

2019

Korean J Pediatr

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Background: The esophagus is the most common part of gastrointestinal (GI) tract at the risk of stricture. Benign disorders are the leading causes of narrowing. Caustic ingestion is the most common cause of esophageal stricture in children, especially in developing countries. Clinical responses to the topical application of Mitomycin C in various medical procedures have been reported. Purpose: The study aimed to evaluate the methodology, efficacy, and side effects of Mitomycin C in the treatment of esophageal strictures. Methods: This study included 30 children with resistant esophageal strictures. Upper GI endoscopy was performed up to the area of stricture, esophageal dilatation was done, endoscopy was repeated, and Mitomycin C was applied topically under direct endoscopic vision. The effect of the procedure was followed over a period of 3-5 years. Results: The response to Mitomycin C was excellent (clinically and endoscopically) in 28 patients (93.3%) and good (endoscopically only) in 2 patients (6.7%). No side effects of topical Mitomycin C in children with esophageal strictures were reported in this study. Conclusion: Esophageal dilatation followed by local Mitomycin C application may be a useful strategy for treating resistant esophageal strictures.

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Section: Discussioncontrasting

confidence: 97%

Endoscopic postdilatation application of Mitomycin C in children with resistant esophageal strictures

Rashed

El‐Guindi

2019

Korean J Pediatr

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“…Other studies that did not meet inclusion criteria for this systematic review have reported complications such as fungal infection, keloid scarring, granuloma and mediastinal emphysema following MMC in airway surgery. An oesophageal trial was interrupted because all of the first three patients experienced intense neck pain after MMC injection 43 . It is, of course, difficult to attribute causality of these outcomes to MMC.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of mitomycin C in Otolaryngology procedures: A systematic review

Luu

Téllez

Chadha

2021

Clinical Otolaryngology

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Objective: Many studies have evaluated the effectiveness of topical intraoperative mitomycin (MCC) usage in a wide range of otolaryngologic procedures with variable conclusions on effectiveness. This systematic review aims to provide a qualitative estimation of mitomycin C's treatment effectiveness in maintaining or preventing stenosis after surgical interventions.Design and Setting: Following the PRISMA guideline, a comprehensive systematic search of MEDLINE, EMBASE and CINAHL databases was performed including handsearching and cross-reference checking. Participants:The search was limited to humans, sample size greater than two and study designs including a comparative arm.Main Outcome Measures: Outcome measures varied but included rates of restenosis, number of procedures, and post-surgical patency.Results: A total of 571 unique abstracts and 109 full articles were reviewed. Seventyseven studies were included in the final analysis. The available evidence ranged from case series to randomized control studies. Meta-analysis was deemed inappropriate due to heterogeneity of study design. Thirty-eight studies assessed the effective of MCC in dacryocystorhinostomy, which is reported in a separate meta-analysis. All other studies were categorized into otolaryngologic site and pathology including choanal atresia (n = 5), endoscopic sinus surgery (n = 12), airway procedures (n = 9), esophageal procedures (n = 8) and other (n = 2). Conclusions:The published literature on the effectiveness of MMC was mixed, but suggested topical MMC improved surgical outcomes in many otolaryngologic procedures compared to controls. This was the first review to assemble literature on MMC usage for different surgical procedures. Comprehensive interpretation of the data was limited due to heterogeneity in primary outcome, procedure type and study quality. High-quality prospective and randomized controlled studies are required to further confirm the positive effect of MMC use on surgical outcomes.

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“…These authors used cotton sponges soaked in MMC or spraying as a method of application. None of these authors applied MMC by direct infiltration at the stricture site despite it being reported as safe and more effective in adult series because of more precise dose calculation and exact stricture site application (15)(16)(17)(18). Most articles, including controlled trials, have proven MMC to be beneficial and safe (2,4,5).…”

Section: Discussionmentioning

confidence: 99%

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

Wishahy

Seleim

Qinawy

et al. 2019

J. pediatr. gastroenterol. nutr.

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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 postcorrosive oesophageal stricture (OS). Methods: Children referred to Cairo University Specialized Paediatric Hospital with refractory postcorrosive 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, 17 children met the inclusion criteria. There were 7 boys and 10 girls. 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 6 months. Seven patients experienced postdilation 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.

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Endoscopic Injection of Mitomycin C for the Treatment of Pharyngoesophageal Stenosis Refractory to Endoscopic Treatment with Dilatation in Patients Treated for Head and Neck Cancer

Cited by 6 publications

References 20 publications

Endoscopic postdilatation application of Mitomycin C in children with resistant esophageal strictures

Endoscopic postdilatation application of Mitomycin C in children with resistant esophageal strictures

The effectiveness of mitomycin C in Otolaryngology procedures: A systematic review

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

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