Reichert Lara K, Zhao Alice S, Galati Lisa T, Shapshay Stanley M
Department of Otolaryngology, University of Texas Medical Branch, Galveston, Tex., USA.
ORL J Otorhinolaryngol Relat Spec. 2015;77(6):351-8. doi: 10.1159/000439174. Epub 2015 Oct 10.
BACKGROUND/AIMS: Laryngotracheal stenosis (LTS) is a difficult entity to treat, with many patients requiring multiple procedures. Our study assessed the efficacy of mitomycin C (MMC) application as complimentary treatment of LTS.
We reviewed clinical charts of patients with operative procedures for LTS between January 2005 and May 2013. Patients were grouped according to mitomycin use. Several outcome measures were assessed, including the number of procedures and time between procedures.
Seventy-one patients were included in the study (30 MMC, 41 non-MMC). They underwent similar numbers of procedures (2.3 MMC, 2.0 non-MMC, p > 0.05). The average time between procedures was 360 (MMC) and 178 (non-MMC) days (p = 0.015). Multiple treatments with mitomycin increased the duration between procedures (366 vs. 340 days, multiple vs. single application, p > 0.05). Fewer mitomycin patients underwent procedures for respiratory distress than non-MMC patients (6.6 vs. 19.5%, p > 0.05). Mitomycin use increased the duration between procedures in patients treated specifically for subglottic stenosis (375 vs. 186 days, p > 0.05).
Our results and experiences with mitomycin demonstrate it is an effective agent for adjuvant treatment of LTS. Its use lengthens the symptom-free period, with further improvement demonstrated when patients expected to undergo multiple surgeries receive multiple mitomycin treatments.
背景/目的:喉气管狭窄(LTS)是一种难以治疗的疾病,许多患者需要多次手术。我们的研究评估了丝裂霉素C(MMC)作为LTS辅助治疗的疗效。
我们回顾了2005年1月至2013年5月期间接受LTS手术治疗患者的临床病历。根据是否使用丝裂霉素将患者分组。评估了几个结果指标,包括手术次数和两次手术之间的时间。
71名患者纳入研究(30名使用MMC,41名未使用MMC)。他们接受的手术次数相似(使用MMC组为2.3次,未使用MMC组为2.0次,p>0.05)。两次手术之间的平均时间分别为360天(使用MMC组)和178天(未使用MMC组)(p=0.015)。多次使用丝裂霉素会延长两次手术之间的时间(366天对340天,多次使用对单次使用,p>0.05)。与未使用MMC的患者相比,使用丝裂霉素的患者因呼吸窘迫而进行手术的较少(6.6%对19.5%,p>0.05)。在专门治疗声门下狭窄的患者中,使用丝裂霉素会延长两次手术之间的时间(375天对186天,p>0.05)。
我们使用丝裂霉素的结果和经验表明,它是LTS辅助治疗的有效药物。它的使用延长了无症状期,当预期接受多次手术的患者接受多次丝裂霉素治疗时,效果进一步改善。