Mitomycin-c application in airway stenosis surgery: analysis of safety and costs

Otolaryngol Head Neck Surg. 2006 Mar;134(3):403-6. doi: 10.1016/j.otohns.2005.10.057.

Abstract

Objective: This study describes a large series of patients receiving topical mitomycin-c (MMC) during airway surgery, including complications, and carries out a cost analysis for its use in laryngotracheal stenosis.

Study design and setting: Retrospective review, tertiary center. Airway patients receiving MMC are reviewed for demographics, stenosis characteristics, and MMC usage. A basic cost analysis is carried out.

Results: Fifty patients underwent 93 MMC applications (mean = 50.8 years, 25 male, 25 female). In 89 of 93 applications (96%), the concentration of MMC was 0.4 mg/ml. One major complication occurred (1.1%). The expense for MMC is $455; the mean cost for airway surgery is $7,840. It is estimated that if 1 of 17 MMC treated patients requires one less operation, the cost ratio is favorable.

Conclusions: This large series contributes to literature that MMC is a safe adjunct to laryngotracheal surgery. The marginal cost for MMC application is favorable based on our basic cost analysis and existing efficacy data.

Significance: Mitomycin-c seems to be safe and cost-effective in endoscopic airway surgery.

Ebm rating: C-4.

MeSH terms

  • Anesthesia, General / economics
  • Cost-Benefit Analysis
  • Costs and Cost Analysis
  • Dilatation
  • Drug Costs
  • Female
  • Hospital Costs
  • Humans
  • Laryngoscopy / economics
  • Laryngostenosis / economics
  • Laryngostenosis / surgery*
  • Laser Therapy / economics
  • Male
  • Middle Aged
  • Mitomycin / adverse effects
  • Mitomycin / economics
  • Mitomycin / therapeutic use*
  • Nucleic Acid Synthesis Inhibitors / adverse effects
  • Nucleic Acid Synthesis Inhibitors / economics
  • Nucleic Acid Synthesis Inhibitors / therapeutic use*
  • Operating Rooms / economics
  • Photography / economics
  • Retrospective Studies
  • Time Factors
  • Tracheal Stenosis / economics
  • Tracheal Stenosis / surgery*
  • Treatment Outcome

Substances

  • Nucleic Acid Synthesis Inhibitors
  • Mitomycin