title: Effect of mitomycin in the surgical treatment of tracheal stenosis.
abstract: OBJECTIVE
  To assess the capacity of high and low doses of the antimitotic drug mitomycin to prevent laryngeal stenosis in an animal model.
  
  
  METHODS
  A prospective, randomized, double-blind, controlled study was carried out. End-to-end anastomosis was performed in 18 rabbits after tracheal annulus resection to produce inflammation. There were 3 treatment groups: topical saline (isotonic sodium chloride solution) and low-dose (0.2 mg/mL) and high-dose (0.5 mg/mL) topical mitomycin.
  
  
  RESULTS
  A total of 107 procedures were performed: 54 surgical procedures, 35 fibrobronchoscopies, and 18 biopsies. The effect of mitomycin was dose related. In the high-dose mitomycin group, most rabbits progressed to stenosis with a percentage decrease in airway diameter that was significantly greater than in the other 2 groups (P <.001). The mean (SD) percentage of maximum stenosis in the high-dose group was 51% (22%). In the low-dose and saline groups, it was 18% (13%) and 16% (9%), respectively. No significant differences in tracheal stenosis between the low-dose mitomycin and saline groups were observed. Blinded histopathological analysis also showed no significant differences between the saline group and the low-dose mitomycin group. Compared with the other 2 groups, the high-dose mitomycin group had a significant increase in fibroproliferative tissue (P <.001).
  
  
  CONCLUSIONS
  These results suggest that topical mitomycin is not effective for avoiding tracheal stenosis and may provoke the opposite effect if the dose is not carefully selected.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. riniguez@uc.cl
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Iñiguez-Cuadra
authors.forename: José
authors.initials: J
authors.lastname: San Martín Prieto
authors.forename: Magaly
authors.initials: M
authors.lastname: Iñiguez-Cuadra
authors.forename: Sergio
authors.initials: S
authors.lastname: Zúñiga Erranz
authors.forename: David
authors.initials: D
authors.lastname: Jofré Pavez
authors.forename: Sergio
authors.initials: S
authors.lastname: González Bombardiere
authors.forename: J M
authors.initials: JM
authors.lastname: Guilemany Toste
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Iñiguez-Sasso
mesh_terms: D000402:Airway Obstruction / Q000473:pathology / Q000517:prevention & control; D000714:Anastomosis, Surgical; D000818:Animals; D050256:Antimitotic Agents / Q000494:pharmacology*; D001706:Biopsy; D001999:Bronchoscopy; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D007828:Laryngoscopy; D007829:Laryngostenosis / Q000473:pathology / Q000517:prevention & control*; D007830:Larynx / Q000473:pathology / Q000601:surgery; D016685:Mitomycin / Q000494:pharmacology*; D011183:Postoperative Complications / Q000473:pathology / Q000517:prevention & control*; D011446:Prospective Studies; D011817:Rabbits; D014132:Trachea / Q000473:pathology / Q000601:surgery*; D014135:Tracheal Stenosis / Q000473:pathology / Q000517:prevention & control*
chemical_list: D050256:Antimitotic Agents; D016685:Mitomycin