Esophageal strictures: Management beyond dilation

Table 7 Characteristics of the studies (with at least 5 patients) that evaluated the effect of mitomycin application for refractory esophageal strictures, n (%)

Ref.	Study type and number of patients	Etiology of stricture	Number of applications	Outcome
Rosseneu et al[37], 2007	Prospective clinical trial, n = 15	Caustic: 9, anastomotic: 9, peptic: 2, Crohn’s: 1, and dystrophic epidermolysis bullosa: 1	Median: 2	Stricture resolution: Complete: 10, partial: 2, no improvement: 3
Gillespie et al[38], 2007	Case series, n = 12	Radiation: 11 and anastomotic: 1	Mean: 1	Stricture resolution: Complete: 11 (91.7), partial: 1 (8.3) and required two additional sessions
Coopman et al[39], 2009	Case series, n = 6	Caustic: 3 and esophageal atresia: 3	Mean: 1.5	All have clinical and endoscopic improvement
Machida et al[40], 2012	Case series, n = 5	Post endoscopic submucosal dissection: 5	Mean: 1.6	All have resolution of symptoms without further dilations
El-Asmar et al[34], 2013	RCT, n = 20 (mitomycin arm)	Caustic: 20	Median: 1	Stricture resolution in 80%
El-Asmar et al[41], 2013	Prospective clinical trial, n = 16	Caustic: 16	Mean: 2.4	Stricture resolution in 81.2%
Nagaich et al[42], 2014	Prospective study, n = 12	Caustic: 12	Mean: 4.75	Increased interval for dilations in all
Sweed et al[35], 2015	RCT, n = 18 (mitomycin arm)	Caustic: 18	Median: 1	Dysphagia resolved in all patients
Bartel et al[43], 2016	Case series, n = 9	Anastomotic: 3, radiation: 3, caustic: 2, anastomotic + radiation: 1	Not available	Mean periodic dilation index decreased from 1.53 to 0.39, P = 0.01
Ghobrial et al[33], 2018	RCT, n = 60 (mitomycin arm)	Caustic: 60	Mean: 3.25	Stricture resolution in 81.6% patients compared to only 40% in the control arm (P < 0.0001)

RCT: Randomised controlled trial.