The clinical experience of mitomycin C balloon dilatation in intractable esophageal stricture EUN YOUNG CHANG, YOUNG JU HONG, JUNG-TAK OH, SEOK JOO HAN.

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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 CharacteristicsN=16 Sex (M/F)7/9 Age at Mitomycin C dilatation9.3 months ( ) Body weight at Mitomycin C dilatation6.1 kg ( ) Diameter of stricture3.0 mm ( ) Length of stricture5.3 mm ( ) 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

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: )  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.