Topical Mitomycin C application in the treatment of refractory benign esophageal strictures in adults and comprehensive literature review

Background: Recurrent complex esophageal strictures remain difficult to manage. Aims: To determine the efficacy of topical Mitomycin C application for recurrent benign esophageal strictures. Methods: All patients who underwent balloon dilation followed by topical Mitomycin C application for recurrent benign esophageal strictures were included. Primary outcome was number of dilations and change of dysphagia score. Results: Nine patients with anastomotic (3), radiation-induced (3), caustic (2), and combined anastomotic and radiation-induced (1) strictures were included. Strictures had a mean length of 13.75 mm, diameter of 8.0 mm, and were dilated 10.7 times over a median of 8 months (1.5 dilations per month). Following Mitomycin C application, the need for further dilation decreased to 0.39 dilations per month over a median of 10 months; however, dysphagia scores improved not significantly from 3.2 to 2.6 (mean). Conclusion: In this pilot study, topical Mitomycin C in conjunction with dilation decreased the frequency of esophageal dilations for recurrent benign esophageal strictures. (C) 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.