Intralesional Mitomycin C Injection in Management of Caustic Esophageal Stricture in Children

• Published in: QJM : An International Journal of Medicine Vol. 113; no. Supplement_1
• Main Authors: Abdelhamid, H S, Elasmar, K M, Zaki, A A, Ghanem, W A, Elbehery, M M
• Format: Journal Article
• Language: English
• Published: Oxford University Press 01.03.2020
• Subjects: Caustic esophageal stricture; Intralesional Mitomycin C
• ISSN: 1460-2725; 1460-2393
• DOI: 10.1093/qjmed/hcaa062.001

Abstract Background Corrosive ingestion is a devastating event that induces significant burdens on modern health systems worldwide. The management of resulting esophageal strictures is challenging where endoscopic dilatation is the first line of management with varying rate of success. Aim of the Work We aimed at this work to study the feasibility and safety of intralesional Mitomycin C injection in patients with caustic localized esophageal stricture. Patients and Methods This study has been conducted at Pediatric Surgery Department, Pediatric Hospital, Ain Shams University Hospitals on eight pediatric patients with caustic esophageal stricture with variable degrees of dysphagia. We evaluated the clinical improvement of the dysphagia, as well as the intra and postoperative complications of Mitomycin C injection. Results Eight patients with short caustic esophageal stricture were managed with intralesional Mitomycin C injection adjuvant to endoscopic dilatation. Seven patients were completely cured from dysphagia with at least 6 months dysphagia free period. No intraoperative complications were documented while there were two cases who reported GIT side effect postoperative in the form of colics and non-bilious vomiting that resolved by medical treatment. Conclusion Intralesional Mitomycin C injection could be a good adjuvant therapy with endoscopic dilatation for caustic esophageal stricture. However, long-term observations are mandatory on a large scale of patients.