ABSTRACTS
nature publishing group
Am J Gastroenterol 2014; 109:S1–S39; doi:10.1038/ajg.2014.273
ESOPHAGUS
3 Underutilization of Esophageal Biopsies and Endoscopic Follow-up in Patient Populations at Higher Risk for Eosinophilic Esophagitis Kristina Ross, MD, Wataru Tamura, MD. University of Colorado Anschutz Medical Campus, Denver, CO.
1 Topical Mitomycin-C in Management of Radiation-Induced Esophageal Strictures (RIES) Margarita German, MD, Kerstin Stenson, MD, Ellen MacCracken, MS, CCC-SLP, Donna Nozicka, RN, Maureen Crowley, APN, CNP, Vani Konda, MD. University of Chicago, Chicago, IL. Introduction: Mitomycin-C has been reported in therapy for recurrent esophageal strictures in children, yet there is minimal data to support use in the adult population. The purpose of this retrospective study is to determine if topical mitomycin-C can be incorporated into esophageal dilations in adults with RIES in an effective and safe manner. Methods: We performed a retrospective review of patients with RIES in head and neck cancer patients who underwent endoscopic dilation with at least one application of mitomycin-C between 2010 to 2014. A chart review of all endoscopy, speech/swallow, esophagram, and clinic notes was conducted. Dilations were performed primarily with Savary dilator rods. Mitomycin-C (2mg/mL) was applied topically via pledgits. Dysphagia grade, diameter of stricture, weight and G-tube necessity was recorded prior to first dilation and after last dilation. Dysphagia grade was based upon a validated dysphagia scoring system (0- normal diet, 1- some solid, 2- semi-solid only, 3- liquids only, 4- total dysphagia). An improvement in dysphagia by grade of one or more was considered a successful outcome. Results: Twenty-four patients (14 male, mean age 63 years) were included in this study. All patients were noted to have cricopharyngeal or cervical esophageal strictures. Average time after radiation to first dilation was 38 months (range 1 - 344 months). Initial esophageal caliber ranged from 3mm to 15mm (mean 7.6mm). Mitomycin-C was used in 58 out of 125 procedures (mean of 5 dilations/person). Overall improvement in esophageal caliber size was achieved in 22/24 patients (mean difference of 6.6mm, p