Mitomycin C in the therapy of recurrent esophageal strictures: hype or hope?

Eur J Pediatr Surg. 2012 Apr;22(2):109-16. doi: 10.1055/s-0032-1311695. Epub 2012 Apr 19.


Introduction: Esophageal strictures refractory to conservative treatment represent a major problem in children. The application of Mitomycin C to the site of stricture has been introduced, but the experience with this novel approach remains very limited.

Methods: Systematic review of publications on the topical application of Mitomycin C in children with persistent esophageal stricture.

Results: We identified 11 publications including 31 cases. The underlying cause of stricture was caustic ingestion in 19 (61.2%), esophageal surgery in 7 (22.6%), and others in 5 children (16.2%). The median age of the patients was 48 months (range 4 to 276 months). In the majority of cases cotton pledgets soaked in solution of Mitomycin C were applied endoscopically. Various other techniques such as drug-eluting stents were used. Mitomycin C was applied from 1 to 12 times within intervals from 1 to 12 weeks. The concentrations of Mitomycin C varied considerably between 0.1 and 1 mg/mL. After a mean follow-up time of 22 (6 to 60) months complete relief of symptoms was reported for 21 children (67.7%), and 6 (19.4%) had a partial relief. In four children (12.9%) Mitomycin C treatment failed. No direct or indirect adverse effects were reported.

Conclusion: The short-term results of topical Mitomycin C application for refractory esophageal stricture reported in the literature are very encouraging. Prospective studies are mandatory to determine the optimal time points, dosage, and modalities of treatment before a recommendation can be given.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Administration, Topical
  • Child
  • Child, Preschool
  • Drug-Eluting Stents
  • Endoscopy
  • Esophageal Stenosis / drug therapy*
  • Esophageal Stenosis / etiology
  • Female
  • Humans
  • Infant
  • Male
  • Mitomycin / administration & dosage
  • Mitomycin / therapeutic use*
  • Recurrence
  • Treatment Outcome


  • Mitomycin