Topical application of mitomycin-C as an adjuvant treatment to bronchoscopicprocedures in post-intubation tracheal stenosis [Aplicação tópica de mitomicina-C como adjuvante no tratamentobroncoscópico da estenose traqueal pós-entubação]

Introduction: post-intubation tracheal stenosis (pits) continues to be challenging in terms ofdiagnosis,management and prevention. recurrence is common because of excessive granulation tissue formation and an insidious process of scar contracture. topical application of mitomycin-c(mmc) as an adjuvant treatment for endoscopic management of stenosis has shown good results. the authors aimed to evaluate the results of mmc topical application following bronchoscopicdilatation as an adjuvant in pits treatment. methods: retrospectively selected patients with pits who had had rigid bronchoscopy (rb)dilatation followed by mmc application as adjuvant to endoscopic treatment. mmc in aconcentration of 0.4 mg/ml was applied with a cotton stiletto around the stenotic lesion andgranulation tissue for 3 minutes. results: eleven patients with pits,with a median initial tracheal stenosis of 75% of the lumen,underwent rb/mmc treatment. mean mmc sessions performed/patient was 3.5,with good res-ponse and prolonged decrease in granulation tissue formation in 55% of cases,moderate in 18%and relapse in 27%. mean stenosis improvement was 34%.conclusions: topical mmc application at 0.4 mg/ml concentration seems to be associated withgood results as adjuvant in pits management with decrease in granulation tissue and sustainedimprovement in lumen diameter. © 2013 sociedade portuguesa de pneumologia.