Topical Mitomycin C application in the treatment of refractory benign esophageal strictures in adults and comprehensive literature review

Background Recurrent complex esophageal strictures remain difficult to manage. Aims To determine the efficacy of topical Mitomycin C application for recurrent benign esophageal strictures. Methods All patients who underwent balloon dilation followed by topical Mitomycin C application for recurrent benign esophageal strictures were included. Primary outcome was number of dilations and change of dysphagia score. Results Nine patients with anastomotic (3), radiation-induced (3), caustic (2), and combined anastomotic and radiation-induced (1) strictures were included. Strictures had a mean length of 13.75 mm, diameter of 8.0 mm, and were dilated 10.7 times over a median of 8 months (1.5 dilations per month). Following Mitomycin C application, the need for further dilation decreased to 0.39 dilations per month over a median of 10 months; however, dysphagia scores improved not significantly from 3.2 to 2.6 (mean). Conclusion In this pilot study, topical Mitomycin C in conjunction with dilation decreased the frequency of esophageal dilations for recurrent benign esophageal strictures.