Effect of Topical Mitomycin C as an Adjunct to Dilation Therapy in Esophageal Strictures

Zunaira  Hameed; Muhammad Tariq  Aziz; Muhammad Aslam  Sheikh; Saima Jabeen  Joiya

doi:10.36283/PJMD13-3/007

Authors

Zunaira Hameed The Children’s Hospital and The Institute of Child Health, Multan
Muhammad Tariq Aziz The Children’s Hospital and The Institute of Child Health, Multan
Muhammad Aslam Sheikh The Children’s Hospital and The Institute of Child Health, Multan
Saima Jabeen Joiya The Children’s Hospital and The Institute of Child Health, Multan

DOI:

https://doi.org/10.36283/PJMD13-3/007

Keywords:

Dilation, dysphagia, esophageal strictures, mitomycin C, placebo, topical

Abstract

Background: The treatment of choice for most esophageal strictures is esophageal dilatation but it has a low success rate. This study was conducted to determine the effect of topical mitomycin C as an adjunct to dilatation therapy in esophageal strictures among children.

Methods: This randomized controlled trial was conducted at the Department of Pediatric Gastroenterology, The Children’s Hospital and Institute of Child Health, Multan, Pakistan, from July 2022 to October 2023. Children aged 1-12 years and having esophageal strictures were included. A simple random sampling technique was adopted. Children in the Mitomycin C group received topical mitomycin C (2 mg/20 ml saline) during the endoscopy, whereas the placebo group received normal saline. The counts of dilatation sessions necessary in each group and the proportion of patients who were symptom-free after 12 months of therapy were noted (outcome). IBM-SPSS 26 was used for data analysis with p<0.05 considered significant.

Results: In a total of 76 children, 52 (68.4%) were male. Overall, the mean age was 4.49±1.96 years. The mean age in mitomycin C (n=38) and placebo group (n=38) were 4.85±1.67 years and 4.25±2.27 years, respectively (p=0.1934). After 12 months, patients in the mitomycin C group had a considerably greater rate of therapeutic success than placebo patients did at 12 months follow-up (84.2% vs. 47.4%; p=0.0007). The average number of dilatation sessions needed was considerably lower in the experimental group than in the control group (2.05±0.78 vs. 3.18±1.54, p<0.0001).

Conclusion: Topical mitomycin C when combined with endoscopic dilatations, resulted in much improved outcomes in children with esophageal strictures.

Keywords: Dilation, Dysphagia, Esophageal Strictures, Mitomycin C, Placebo, Topical.

Author Biographies

Zunaira Hameed, The Children’s Hospital and The Institute of Child Health, Multan

Pediatric Gastroenterology Department
Muhammad Tariq Aziz, The Children’s Hospital and The Institute of Child Health, Multan

Pediatric Medicine Department
Muhammad Aslam Sheikh, The Children’s Hospital and The Institute of Child Health, Multan

Pediatric Gastroenterology Department
Saima Jabeen Joiya, The Children’s Hospital and The Institute of Child Health, Multan

Pediatric Gastroenterology Department

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