The clinical experience of mitomycin C balloon dilata-tion in intractable esophageal stricture

EUN YOUNG CHANG, YOUNG JU HONG, JUNG-TAK OH, SEOK JOO HAN

Department of Pediatric Surgery, Severance Children’s Hospital, Department of Surgery, Yonsei University Col-lege of Medicine, Seoul, Korea

Purpose

Esophageal strictures refractory to conservative treatment represent a major problem in chil-dren.

Recently, the application of mitomycin C to the lesion of strictures has been introduced.

We investigated our clinical experience with this procedure in refractory esophageal stricture.

Methods

From September 2011 to September 2013

16 patients: 15 esophageal stricture after the surgery of

esophageal atresia

1 corrosive esophageal injury due to lithium bat-tery ingestion after esophagectomy

Mitomycin C balloon dilatation Drug eluting microporous PTFE balloon catheter

after pre-balloon dilatation under the general anesthesia by intervention radiologist

Methods

Pre- Pre-bal-loon

Mitomycin C After-

Results

Characteristics N=16

Sex (M/F) 7/9

Age at Mitomycin C dilatation 9.3 months (2.9-41.9)

Body weight at Mitomycin C dilatation 6.1 kg (3.2-12.6)

Diameter of stricture 3.0 mm (1.5-8.0)

Length of stricture 5.3 mm (1.1-20.0)

Numbers of esophageal dilatation before pro-cedure

2 (0-8)

Numbers of esophageal dilatation after proce-dure

0 (0-4)

* All variables are expressed by median values with range.

Results Numbers of esophageal dilatation pre-/post- mito-

mycin

Pre-Mitomicyn C Post-Mitomycin C0

1

2

3

4

5

6

7

8

9

Case 1Case 2Case 3Case 4Case 5Case 6Case 7Case 8Case 9Case 10Case 11Case 12Case 13Case 14Case 15Case 16

Results

After Mitomycin C esophageal dilatation, 5 patients were needed further dilatation.

1 : severe small diameter of stricture (1.55mm) (n: 44)

1: lithium battery ingestion, (n:14)

1: clinically severe stenosis: 01

1: decreased, (n:81)

1: decreased, (n:72)

11 patients: never needed further dilatation

Results

Complications one patient

a partial tearing of esophagus during the proce-dure

followed pancytopenia, thrombocytopenia

recovered through conservative treatment

Follow-up duration: 8.3 months(r: 0.5-22.3) All patients were not complain dysphagia

Conclusion

Although this study is retrospective, small sam-ple sized, not randomized, and limited follow-up,

Mitomycin C balloon dilatation in refractory esophageal stricture is safe and feasible.

For further indication, prospective, long-term assessment of outcome is needed.