The efficacy of topical mitomycin-C in the treatment of benign tracheal stenosis: A comparative study.

BACKGROUND

This study aims to examine the efficacy of mitomycin-C (MMC) in patients with benign tracheal stenosis who have re-stenosis requiring repeated interventional bronchoscopy.

METHODS

Between January 2009 and December 2019, a total of 25 patients who underwent repeated procedures for re-stenosis were retrospectively analyzed. The study group consisted of 11 patients (7 males, 4 females; median age: 37 years; range, 16 to 63 years) who underwent MMC following routine dilation and the control group consisted of 14 patients (8 males, 6 females; median age: 52 years; range, 19 to 73 years) who underwent dilation alone and did not receive MMC. Demographic data of the patients, the etiology of stenosis, comorbidities, medications used, imaging studies, location, degree and length of re-stenosis, details of interventional bronchoscopy, pre- and post-procedural time intervals between mechanical dilation, and cost were reviewed.

RESULTS

The percentage changes of re-stenosis and mean re-stenotic segment length significantly decreased (p=0.013 and p=0.029, respectively), and the medical cost (p=0.021), and number of repeated dilations (p=0.020) were lower in the MMC-treated group, compared to the control group. However, the improvement rate was not significantly different (p=0.070) between the MMC-treated group and control group.

CONCLUSION

Mitomycin-C is helpful to decrease the tracheal re-stenosis percentage changes and the number of repeated dilations in patients with benign tracheal stenosis. It also decreases the median re-stenotic segment lengths which may be crucial for limited reserve surgery in tracheal resections. Taken together, MMC is a cost-effective, time-saving and tracheal-sparing treatment in patients with benign tracheal stenosis.