Can mitomycin facilitate endoscopic dilatation treatment of benign oesophageal stricture?

Abstract

A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was 'Can mitomycin facilitate endoscopic dilatation treatment of benign esophageal stricture (mainly including caustic and anastomotic esophageal stricture)?' Altogether, 115 papers were found using the reported search, of which 6 represented the best evidence to answer the clinical question, which included 1 randomized controlled trial, 1 systematic review and 4 cohort studies. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Mytomicin was topically applied as an adjunct to endoscopic dilatation with a concentration of 0.1-1 mg/ml in those included studies. Most of the studies reported that topical application of mitomycin could augment the effect of endoscopic dilatation treatment to achieve less dilatation number and significant improvement of dysphagia in patients suffering benign oesophageal stricture, and would not increase the risk of complications. These satisfying adjunct effects were observed in both child patients and adult patients. Therefore, we conclude that mitomycin can serve as a useful adjunct to endoscopic dilatation for benign oesophageal stricture. On the basis of our evidence, we strongly believe that topical application of mitomycin would augment the efficacy of endoscopic dilatation of benign oesophageal stricture.

Keywords: Mitomycin; Oesophageal stricture.