Steroid Versus Mitomycin-C Use in Pediatric Benign Recurrent Esophageal Stricture

After taking approval from the Institutional Review Board of the university; and taking the informed consent from parents, patients fulfilling the inclusion and exclusion criteria will be enrolled in the study. They will be then randomly allocated into two groups; group A and group B. Patients in Group A will be treated with esophageal dilation with a CRE balloon (controlled radial expansion balloon). After adequate dilation of stricture, injection Mitomycin will be applied to the narrowest portion of the stricture. Patients in Group B will be treated with esophageal dilation with a CRE balloon in the same manner. After adequate dilation of stricture, Triamcinolone injection will be injected into the narrowest portion of the stricture, using a sclerotherapy injector. Dysphagia Severity Score will be noted at start of intervention, at 2 weeks after intervention and at 6 weeks post- intervention.

Inclusion criteria

• Patients up to 16 years of age belonging to both genders
• Patients with single esophageal stricture
• Patients with benign recurrent esophageal strictures
• Patients with any etiology for esophageal stricture including; post-corrosive, congenital, post-anastomotic and eosinophilic.

Exclusion criteria

• Patients unfit for anesthesia and/or hemodynamic instability
• Patients with hemostatic disorder (platelets <50,000 or international normalized ratio >1.5)
• Patients who have undergone esophageal surgery in last one month
• Patients with complications such as; stricture perforation, signs of air leak or mediastinitis
• Those with hypersensitivity to Mitomycin- C
• Patients with multiple strictures