Intramuscular injection of mitomycin C combined with endoscopic dilation for benign esophageal strictures

Abstract

Intramuscular injection of mitomycin C or dexamethasone may prolong the dysphagia-free period and decrease the frequency of repeat dilations compared with conventional endoscopic dilations in patients with benign esophageal strictures.

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

“…We are not sure about this leak, but it is not possible to exclude it. Previous results support MMC injection, but not with short intervals between sessions [ 11 , 17 – 19 ].…”

“…The majority of studies reported topical application of MMC with a variety of application techniques, including cotton pledget, microporous balloon, and spraying technique. However, we found 4 studies with 32 adult patients submitted to MMC injection directly in the stricture after dilation [ 11 , 17 – 19 ].…”

“…Zhang et al and Gillespie et al published the largest studies about the topical use of MMC in adults for esophageal stenoses [ 3 , 19 ]. The patients enrolled had strictures due to anastomosis, radiation, and after ESD.…”

Risk factors associated with refractoriness to esophageal dilatation for benign dysphagia

“…Refractory or recurrent strictures should be defined as an anatomic restriction because of a cicatricial luminal compromise or fibrosis resulting in clinical symptoms of dysphagia in the absence of endoscopic evidence of inflammation [10]. Stratifying patients prone to have strictures refractory to traditional endoscopic therapies may help in earlier selection of patients who should be considered for further endoscopic techniques, such as steroid injections, incisional therapy, stent placement, or surgery [15][16][17][18][19]. Stratifying patients prone to have strictures refractory to traditional endoscopic therapies may help in earlier selection of patients who should be considered for further endoscopic techniques, such as steroid injections, incisional therapy, stent placement, or surgery [15][16][17][18][19].…”

Recurrent esophageal stricture from previous caustic ingestion treated with 40-year self-dilation: case report and review of literature

“…In order to prolong the dysphagia-free period, and to decrease the frequency of repeated dilations compared with conventional endoscopic dilations, intramuscular injections of mitomycin C and steroids were suggested. Mitomycin C is a chemotherapeutic agent derived from some Streptomyces species which reduces scars formation when topically applied to a mucosal lesion, and theoretically should prevents esophageal stenosis in selected cases [ 10 , 11 ]. Nevertheless, there is evidence that triamcinolone and other steroids injection in combination with endoscopic dilation is able to reduce the risk of recurrent dysphagia in refractory benign esophageal strictures of peptic origin, with results coming from small-sized studies with poorly defined population and not concerning caustic ingestion [ 12 ].…”