title: Topical mitomycin-C application in recurrent esophageal strictures after surgical repair of esophageal atresia.
abstract: OBJECTIVE
  The aim of the present study was to evaluate the efficacy and short-term safety of topical mitomycin-C, an antifibrotic agent, in preventing the recurrence of anastomotic strictures after surgical repair of esophageal atresia (EA).
  
  
  METHODS
  We retrospectively reviewed the medical records of patients with recurrent anastomotic strictures after EA surgery who underwent at least 3 esophageal dilations. We compared the outcome (ie, resolution of the stricture) of the group that received topical mitomycin-C treatment with endoscopic esophageal dilation with a historical cohort treated by dilations alone.
  
  
  RESULTS
  A total of 11 children received mitomycin-C concurrently with endoscopic dilations. After a median follow-up of 33 months (range 18-72), and a mean number of 5.4 dilations per patient (range 3-11), 8 of 11 patients achieved a resolution of their strictures, 2 patients remained with stenosis, and 1 patient needed a surgical correction. In the control group, 10 patients required an average of 3.7 (range 3-7) total dilations. After a follow-up of 125 months (range 35-266) after the last dilation, strictures in 9 of 10 children disappeared and the remaining patient was symptom free. No dysplasia related to mitomycin-C was demonstrated.
  
  
  CONCLUSIONS
  There is no benefit in the resolution of the stricture when adding mitomycin-C treatment compared with repeated esophageal dilations alone in historical controls. Further randomized controlled studies and a short- and long-term evaluation of safety are needed.
authors.affiliation: Division of Pediatric Gastroenterology, Sainte-Justine University Hospital Center, Montreal, QC, Canada.
authors.forename: Laurence
authors.initials: L
authors.lastname: Chapuy
authors.forename: Martine
authors.initials: M
authors.lastname: Pomerleau
authors.forename: Christophe
authors.initials: C
authors.lastname: Faure
mesh_terms: D000287:Administration, Topical; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D004933:Esophageal Atresia / Q000601:surgery*; D004940:Esophageal Stenosis / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy* / Q000601:surgery; D012008:Recurrence
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin