Treatment of recurrent esophageal stricture with an insulated-tip electrosurgical knife and mitomycin C

Chiang, Austin L.; Abidi, Wasif M.; Thompson, Christopher C.

doi:10.1055/s-0042-122141

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…As an alternative method, the intralesional or systemic application of corticoids combined with esophageal dilation has been effective in children, especially in complex structures (10) . A large variety of surgical procedures, such as esophagectomy and gastric tube reconstruction, and jejunal or colonic interposition, may also be applied in the resolution of such injuries (29) . Despite technical advances, such procedures still have high morbidity and mortality.…”

Section: Summary Of Evidencementioning

confidence: 99%

Efficacy of Endoscopic Topical Mitomycin C Application in Caustic Esophageal Strictures in the Pediatric Population: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Flor

Ribeiro

Marques

et al. 2021

Arq. Gastroenterol.

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BACKGROUND: Caustic ingestion and development of esophageal strictures are recognized major public health problems in childhood. Different therapeutic methods have been proposed in the management of such strictures. OBJECTIVE: To evaluate efficacy and risk of endoscopic topical application of mitomycin C in the treatment of caustic esophageal strictures. METHODS: We searched MEDLINE, EMBASE, Central Cochrane, and LILACS databases. The outcomes evaluated were dysphagia resolution rate, number of dilations performed in resolved cases, and the number of dilations performed in all patients. RESULTS: Three randomized clinical trials were included for final analysis with a total of 190 patients. Topical mitomycin C application group showed a significant increase in dysphagia resolution rate, corresponding to a 42% higher dysphagia resolution as compared to endoscopic dilation alone, with statistical significance between the two groups (RD: 0.42 - [CI: 0.29-0.56]; P-value <0.00001). The mean number of dilations performed in resolved cases were significantly less in the topical mitomycin C application group, compared to endoscopic dilations alone, with statistical significance between the two groups (MD: 2.84 [CI: 1.98-3.69]; P-value <0.00001). When comparing the number of dilations in all patients, there was no statistical difference between the two groups (MD: 1.46 [CI: -1.53-4.44]; P-value =0.34). CONCLUSION: Application of topical mitomycin C with endoscopic dilations in caustic esophageal strictures was more effective in dysphagia resolution than endoscopic therapy alone in the pediatric population. Moreover, topical mitomycin C application also reduced the number of dilation sessions needed to alleviate dysphagia without rising morbidity.

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Section: Summary Of Evidencementioning

confidence: 99%

Efficacy of Endoscopic Topical Mitomycin C Application in Caustic Esophageal Strictures in the Pediatric Population: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Flor

Ribeiro

Marques

et al. 2021

Arq. Gastroenterol.

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Endoscopic management of benign recalcitrant esophageal strictures

Boregowda

Goyal

Mann

et al. 2021

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Benign esophageal strictures are one of the common clinical conditions managed by endoscopists. Nearly 90% of the benign esophageal strictures respond to endoscopic dilation. However, a small percentage of patients progress to recalcitrant strictures. The benign recalcitrant esophageal strictures are difficult to manage both medically and endoscopically as they do not respond to conventional treatment with proton pump inhibitors and esophageal dilations. Patients with benign recalcitrant esophageal strictures are at a high risk of developing debilitating malnutrition and morbidity due to severe dysphagia. This condition is associated with psychological trauma to patients as treatments are usually prolonged with poor outcomes. Also, this can be a financial burden on the healthcare industry due to several sessions of treatment. In this article, we discuss the classification of benign esophageal strictures, evidence-based treatment strategies, endoscopic procedural techniques, and complications of endoscopic interventions. We aim to guide providers in managing benign esophageal strictures with a focus on endoscopic management of benign recalcitrant esophageal strictures.

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Treatment of recurrent esophageal stricture with an insulated-tip electrosurgical knife and mitomycin C

Cited by 2 publications

References 5 publications

Efficacy of Endoscopic Topical Mitomycin C Application in Caustic Esophageal Strictures in the Pediatric Population: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Efficacy of Endoscopic Topical Mitomycin C Application in Caustic Esophageal Strictures in the Pediatric Population: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Endoscopic management of benign recalcitrant esophageal strictures

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