title: Topical mitomycin C application is effective in management of localized caustic esophageal stricture: a double-blinded, randomized, placebo-controlled trial.
abstract: BACKGROUND
  Frequent sessions of endoscopic dilatation are usually required in the management of benign esophageal strictures, especially caustic induced ones. Topical mitomycin C (MMC) has been recently used in the management of resistant strictures. This study evaluated the efficacy of MMC application in prevention of stricture recurrence after endoscopic dilatation.
  
  
  METHODS
  This double-blind, randomized, placebo-controlled trial included forty patients with caustic esophageal strictures dating from January 2008 to October 2010. Patients were randomized into 2 groups to undergo endoscopic dilatation with application of either MMC versus placebo on stricture site. Regular follow up and re-evaluation were done after 6 months of management. The number of dilatation sessions needed for resolution of dysphagia in each group was our primary outcome.
  
  
  RESULTS
  During the specified follow up period, 80 % of strictures in the MMC group got completely resolved compared to only 35% in the placebo group. The mean number of dilatation sessions needed in the MMC group was n = 3.85 ± 2.08 compared to n = 6.9 ± 2.12 in the placebo group which was statistically significant (p < 0.001).
  
  
  CONCLUSIONS
  Mitomycin C application significantly reduced the number of dilatation sessions needed to alleviate dysphagia in patients with caustic esophageal strictures.
authors.affiliation: Department of Pediatric Surgery, Ain Shams University, Cairo, Egypt. khaled80@hotmail.com
authors.forename: Khaled M
authors.initials: KM
authors.lastname: El-Asmar
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Hassan
authors.forename: Hesham M
authors.initials: HM
authors.lastname: Abdelkader
authors.forename: Alaa F
authors.initials: AF
authors.lastname: Hamza
mesh_terms: D000287:Administration, Topical; D002057:Burns, Chemical / Q000188:drug therapy*; D002424:Caustics / Q000633:toxicity*; D002675:Child, Preschool; D004311:Double-Blind Method; D004940:Esophageal Stenosis / Q000139:chemically induced* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage*; D011446:Prospective Studies
chemical_list: D002424:Caustics; D016685:Mitomycin
keywords: Caustic esophageal stricture; Endoscopic dilatation; Mitomycin C