Treatment of Refractory Gastrointestinal Strictures With Mitomycin C: A Systematic Review.

摘要: Background and aims Refractory benign gastrointestinal (GI) strictures represent a difficult management problem given the limited therapeutic interventions available. We performed systematic review of all published cases using mitomycin C in treatment GI strictures. Methods Searches MEDLINE Embase databases were to identify studies reporting application for Review titles/abstracts, full potentially relevant studies, data abstraction independently by 2 authors. Results Of 549 citations, 24 with 145 patients (74% pediatric 26% adult) met inclusion criteria. Esophageal most common (79%) site refractory treated C, caustic injury underlying etiology. The concentration (range, 0.1 mg/mL; median, 0.4 mg/mL), number applications 1 12; 1), duration 5; min), technique (cotton pledget, spray, injection, special catheters) varied among studies. Ninety-one (73%; children: 80%, adults: 59%) had complete response; 26 (21%) partial response. Only (0.7%) adverse event was reported: cutaneous sclerosis attributed microperforation extravastion after injection. Mean follow-up 23 (4 60) months. Conclusions Local seems be safe effective therapy varying etiology both adult populations. Although results this are highly encouraging, it should considered investigational. Additional randomized trials larger prospective needed confirm these better define optimal dose, concentration, application.