Rashed Yasser K, El-Guindi Mohamed
Department of Pediatric Hepatology, National Liver Institute, Menoufiya University, Menoufia, Egypt.
Department of Pediatric Hepatology, Gastroenterology and Nutrition, National Liver Institute, Menoufia University, Menoufia, Egypt.
Korean J Pediatr. 2019 Oct;62(10):395-399. doi: 10.3345/kjp.2018.07157. Epub 2019 Jun 24.
The esophagus is the most common part of gastrointestinal (GI) tract at the risk of stricture. Benign disorders are the leading causes of narrowing. Caustic ingestion is the most common cause of esophageal stricture in children, especially in developing countries. Clinical responses to the topical application of Mitomycin C in various medical procedures have been reported.
The study aimed to evaluate the methodology, efficacy, and side effects of Mitomycin C in the treatment of esophageal strictures.
This study included 30 children with resistant esophageal strictures. Upper GI endoscopy was performed up to the area of stricture, esophageal dilatation was done, endoscopy was repeated, and Mitomycin C was applied topically under direct endoscopic vision. The effect of the procedure was followed over a period of 3-5 years.
The response to Mitomycin C was excellent (clinically and endoscopically) in 28 patients (93.3%) and good (endoscopically only) in 2 patients (6.7%). No side effects of topical Mitomycin C in children with esophageal strictures were reported in this study.
Esophageal dilatation followed by local Mitomycin C application may be a useful strategy for treating resistant esophageal strictures.
食管是胃肠道中最易发生狭窄的部位。良性疾病是导致狭窄的主要原因。腐蚀性物质摄入是儿童食管狭窄最常见的原因，在发展中国家尤为如此。已有关于丝裂霉素C在各种医疗程序中局部应用的临床反应的报道。
本研究旨在评估丝裂霉素C治疗食管狭窄的方法、疗效和副作用。
本研究纳入了30例难治性食管狭窄患儿。对上消化道进行内镜检查直至狭窄部位，进行食管扩张，重复内镜检查，并在内镜直视下局部应用丝裂霉素C。对该治疗过程的效果进行了3至5年的随访。
28例患者（93.3%）对丝裂霉素C的反应极佳（临床和内镜检查均显示），2例患者（6.7%）反应良好（仅内镜检查显示）。本研究未报告丝裂霉素C局部应用于食管狭窄患儿的副作用。
食管扩张后局部应用丝裂霉素C可能是治疗难治性食管狭窄的有效策略。
