The clinical experience of
mitomycin C balloon dilatation
in intractable esophageal
stricture
EUN YOUNG CHANG, YOUNG JU HONG, JUNG-TAK
OH, SEOK JOO HAN
Department of Pediatric Surgery, Severance Children’s
Hospital, Department of Surgery, Yonsei University
College of Medicine, Seoul, Korea
Purpose

Esophageal strictures refractory to conservative
treatment represent a major problem in children.

Recently, the application of mitomycin C to the
lesion of strictures has been introduced.

We investigated our clinical experience with this
procedure in refractory esophageal stricture.
Methods

From September 2011 to September 2013

16 patients:


15 esophageal stricture after the surgery of
esophageal atresia

1 corrosive esophageal injury due to lithium battery
ingestion after esophagectomy
Mitomycin C balloon dilatation

Drug eluting microporous PTFE balloon catheter after
pre-balloon dilatation under the general anesthesia by
intervention radiologist
Methods
Pre-
Pre-balloon
Mitomycin C
After-
Results
Characteristics
N=16
Sex (M/F)
7/9
Age at Mitomycin C dilatation
9.3 months (2.9-41.9)
Body weight at Mitomycin C dilatation
6.1 kg (3.2-12.6)
Diameter of stricture
3.0 mm (1.5-8.0)
Length of stricture
5.3 mm (1.1-20.0)
Numbers of esophageal dilatation before
procedure
2 (0-8)
Numbers of esophageal dilatation after
procedure
0 (0-4)
* All variables are expressed by median values with range.
Results

Numbers of esophageal dilatation pre-/post- mitomycin
9
Case 1
8
Case 2
Case 3
7
Case 4
Case 5
6
Case 6
Case 7
5
Case 8
4
Case 9
Case 10
3
Case 11
Case 12
2
Case 13
Case 14
1
Case 15
Case 16
0
Pre-Mitomicyn C
Post-Mitomycin C
Results

After Mitomycin C esophageal dilatation,


5 patients were needed further dilatation.

1 : severe small diameter of stricture (1.55mm) (n: 44)

1: lithium battery ingestion, (n:14)

1: clinically severe stenosis: 01

1: decreased, (n:81)

1: decreased, (n:72)
11 patients: never needed further dilatation
Results


Complications

one patient

a partial tearing of esophagus during the procedure

followed pancytopenia, thrombocytopenia

recovered through conservative treatment
Follow-up duration: 8.3 months(r: 0.5-22.3)

All patients were not complain dysphagia
Conclusion

Although this study is retrospective, small sample
sized, not randomized, and limited follow-up,

Mitomycin C balloon dilatation in refractory
esophageal stricture is safe and feasible.

For further indication, prospective, long-term
assessment of outcome is needed.