Endoscopic dilation combined with intramuscular injection of mitomycin C for benign esophageal strictures

Abstract

Objective To evaluate the safety and efficacy of an endoscopic dilation in association with the intramuscular injection of either mitomycin C for benign esophageal strictures. Methods A total of 89 patients with benign esophageal strictures were retrospectively divided into 3 groups, including 30 cases of dilation combined with mitomycin C injection (mitomycin C group), 29 of dilation combined with dexamethasone injection (dexamethasone group) and 30 of dilation with saline injection (dilation group). The successful rate, complications and the clinical effect in the 3 groups were compared. Results The 89 patients all successfully received the procedure, with the endoscopic and clinical release. No massive hemorrhage occurred. In mitomycin C group, 1 case with major complication (perforation) and 7 minor complication occurred; 9 and 7 cases with minor complication occurred in dexamethasone group and dilation group, respectively. There were no significant difference of the complications in the 3 groups (P<0.05). The mean dysphagia-free period was 5.25±1.18 months in the mitomycin C group, 4.46±1.53 months in the dexamethasone group, and 3.03±1.62 months in the dilation group (P<0.05). Conclusion Endoscopic dilation with or without the intramuscular injection of either mitomycin C or dexamethasone are safe and effective. Dilation combined with drug injection may prolong the esophageal dysphagia-free period. Furthermore, mitomycin C injection may have the dominant effect. Key words: Mitomycin; Dexamethasone; Endoscopic dilation; Esophageal benign stricture