Department of Gastroenterology, SMS Medical College Jaipur, Jaipur, India.
Dis Esophagus. 2014 Apr;27(3):203-5. doi: 10.1111/dote.12092. Epub 2013 Jun 24.
Increasingly frequent dilation may become a self-defeating cycle in refractory stricture as recurrent trauma enhance, scar formation, and ultimately recurrence and potential worsening of the stricture. In 12 patients of caustic induced esophageal stricture, who failed to respond despite rigorous dilatation regimen for more than one year, a trial of topical mitomycin-C application to improve dilatation results was undertaken, considering the recently reported efficacy and safety of this agent. Mitomycin-C was applied for 2-3 minutes at the strictured esophageal segment after dilation with wire-guided Savary-Gilliard dilator. Patient was kept nil by mouth for 2-3 hours. After 4-6 sessions of mitomycin-C treatment, resolution of symptoms and significant improvement in dysphagia score and periodic dilatation index was seen in all 12 patients. Mitomycin-C topical application may be a useful strategy in refractory corrosive esophageal strictures and salvage patients from surgery.
在难治性狭窄中，频繁的扩张可能会成为一个自我挫败的循环，因为反复的创伤会加重、疤痕形成，最终导致狭窄的复发和潜在恶化。在 12 例因腐蚀性物质导致食管狭窄的患者中，尽管进行了严格的扩张治疗方案超过一年，但仍未得到缓解，考虑到该药物最近报道的疗效和安全性，我们尝试使用局部丝裂霉素 C 来改善扩张效果。在使用导丝引导的 Savary-Gilliard 扩张器扩张后，将丝裂霉素 C 应用于狭窄的食管段 2-3 分钟。患者保持禁食 2-3 小时。在进行 4-6 次丝裂霉素 C 治疗后，12 例患者的症状均得到缓解，吞咽困难评分和定期扩张指数均显著改善。局部应用丝裂霉素 C 可能是治疗难治性腐蚀性食管狭窄的一种有效策略，可以使患者免于手术。
