丝裂霉素治疗食管良性狭窄的临床应用进展

Clinical application of mitomycin C in benign esophageal stricture

食管良性狭窄是由多种原因导致的慢性食管非肿瘤性损伤及纤维化从而引起的临床常见疾病,随着近年来针对食管癌早期筛查的微创手术内镜黏膜下剥离术(ESD)及食管癌根治术的不断增加,食管良性狭窄发生率也越来越高。内镜下扩张为其首选治疗方案,但对于顽固性狭窄,反复扩张易增加穿孔及出血风险,治疗效果有限。丝裂霉素(mitomycin C,MMC)最初是一种抗肿瘤药物,也被作为抗纤维增生药物应用于临床,被用于抗食管良性狭窄已接近20年,其安全性及有效性得到了证实,然而,其使用方法及浓度在不同报道中却差别很大。因此,本文对丝裂霉素在食管良性狭窄中的临床应用进行综述。

Benign esophageal stricture is a common disease caused by chronic non⁃tumor esophageal injury and fibrosis.With the rapid increase of endoscopic submucosal dissection(ESD)and radical esophageal surgery for early esophageal cancer in recently years,the incidence of benign esophageal stricture is also increasing.Endo⁃scopic dilation is the first choice.However,for refractory esophageal benign stricture,the repeated dilation often leads to procedure⁃related perforation and bleeding with lower efficiency.MMC was originally an anti⁃tumor agent,and it was also used as an anti⁃fibroproliferative drug.MMC has been used in the treatment of benign esophageal stricture for nearly 20 years,and its safety and effectiveness have been confirmed.However,the delivery method and concentration varied greatly in different reports.Therefore,this article will review the clinical application of MMC in benign esophageal stricture.