Mitomycin C prevents strictures in caustic esophageal burns in rats.
BACKGROUND
Caustic esophageal injuries lead to stricture formation. Although a number of agents have been tried experimentally to prevent strictures, few have gained clinical application. The purpose of this study was to investigate the effectiveness of Mitomycin C (MMC), which inhibits fibroblastic proliferation in preventing caustic esophageal strictures.


METHODS
Fifty-six rats were allocated into four groups. Caustic esophageal burns were created as described by Gehanno. Group A was instilled only with saline. Group B was injured and untreated. Groups C and D were injured and received topical MMC at 0.02 and 0.04% concentrations, respectively. At 28 days, stenosis index (SI), collagen deposition, and hydroxyproline content (HP) were determined in distal esophageal segments. Statistical analyses were done.


RESULTS
Mean SI in Group B was significantly higher than others (P < 0.05). Mean SI was statistically higher in Group C than A and D and similar between groups A and D. The greatest accumulation of collagen was found in Group B, followed by Group C, D, and A, respectively. Collagen deposition in Group D was statistically lower than Group B (P < 0.01) and similar to Group C. Mean HP in Group B was statistically higher than others (P < 0.05), significantly higher in Group C than Group D (P = 0.047), and similar between Groups A and D (P = 0.73).


CONCLUSIONS
MMC was effective in preventing strictures following experimental caustic esophageal injury, in a dose-dependent manner. We consider that it can gain clinical utilization with the establishment of effective mode, dose, and timing of therapy.
Türkyilmaz
Zafer
Z
Department of Pediatric Surgery, Gazi University Faculty of Medicine, Ankara, Turkey. zafertrk@yahoo.com
Sönmez
Kaan
K
Demirtola
Arzu
A
Karabulut
Ramazan
R
Poyraz
Aylar
A
Gülen
Sebnem
S
Dinçer
Sibel
S
Başaklar
A Can
AC
Kale
Nuri
N
D000468:Alkalies / Q000506:poisoning; D000818:Animals; D000903:Antibiotics, Antineoplastic / Q000494:pharmacology*; D001835:Body Weight; D002057:Burns, Chemical / Q000188:drug therapy* / Q000473:pathology; D004195:Disease Models, Animal; D004940:Esophageal Stenosis / Q000188:drug therapy* / Q000473:pathology / Q000517:prevention & control*; D004947:Esophagus / Q000378:metabolism / Q000473:pathology; D006909:Hydroxyproline / Q000378:metabolism; D016685:Mitomycin / Q000494:pharmacology*; D051381:Rats; D017208:Rats, Wistar
D000468:Alkalies; D000903:Antibiotics, Antineoplastic; D016685:Mitomycin; D006909:Hydroxyproline