title: Mitomycin C in the therapy of recurrent esophageal strictures: hype or hope?
abstract: BACKGROUND
  Esophageal strictures refractory to conservative treatment represent a major problem in children. The application of Mitomycin C to the site of stricture has been introduced, but the experience with this novel approach remains very limited.
  
  
  METHODS
  Systematic review of publications on the topical application of Mitomycin C in children with persistent esophageal stricture.
  
  
  RESULTS
  We identified 11 publications including 31 cases. The underlying cause of stricture was caustic ingestion in 19 (61.2%), esophageal surgery in 7 (22.6%), and others in 5 children (16.2%). The median age of the patients was 48 months (range 4 to 276 months). In the majority of cases cotton pledgets soaked in solution of Mitomycin C were applied endoscopically. Various other techniques such as drug-eluting stents were used. Mitomycin C was applied from 1 to 12 times within intervals from 1 to 12 weeks. The concentrations of Mitomycin C varied considerably between 0.1 and 1 mg/mL. After a mean follow-up time of 22 (6 to 60) months complete relief of symptoms was reported for 21 children (67.7%), and 6 (19.4%) had a partial relief. In four children (12.9%) Mitomycin C treatment failed. No direct or indirect adverse effects were reported.
  
  
  CONCLUSIONS
  The short-term results of topical Mitomycin C application for refractory esophageal stricture reported in the literature are very encouraging. Prospective studies are mandatory to determine the optimal time points, dosage, and modalities of treatment before a recommendation can be given.
authors.affiliation: Virgen del Rocío Children's Hospital, Seville, Spain.
authors.forename: Michael
authors.initials: M
authors.lastname: Berger
authors.forename: Benno
authors.initials: B
authors.lastname: Ure
authors.forename: Martin
authors.initials: M
authors.lastname: Lacher
mesh_terms: D000287:Administration, Topical; D002648:Child; D002675:Child, Preschool; D054855:Drug-Eluting Stents; D004724:Endoscopy; D004940:Esophageal Stenosis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage / Q000627:therapeutic use*; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D016685:Mitomycin