A Meta-analysis Of The Effectiveness Of Mitomycin C Treatment In The Benign Tracheal Stenosis

Objective: A systematic evaluation of the effectiveness of mitomycin C treatment in the benign tracheal stenosis was carried out by evidence-based medicine methods.Methods: A method for the Meta-analysis of incorporating the clinical literatures concerning the randomized controlled trial(RCT)of patients and animal models with benign tracheal stenosis caused by various reasons be treated with other methods and auxiliary application of mitomycin C were searched from PUBMED(1996-2015),OVID(1966-2015),EMbase,Cochrane,CNKI database,Dayi database.Qualities of literatures were evaluated by the modified Jadad score ofrandomized controlledtrial.Outcome evaluation indexes: MMC group and the intervention group after treatment the airway diameter index,degree of stenosis and shortness of breath.The meta—analysis was performed by RevMan 5.3 statistical software and stata 12.0 statistical software.Results: Six RCT research were included in this meta-analysis.Including a total of 89 patients(SW/SC 49/40),48 experimental animals(SW/SC 15/23).In the treatment of the secondary application of MMC for airway stenosis scheme,there is no statistical difference between inclusion criteria of patients,animal model establishment,the degree of patients with airway stenosis before treated.In RCT test consolidate the homogeneity data and analysis the sources of heterogeneit data.Meta analysis showed that compared with the simple application of endoscopic interventional treatment,auxiliary application of mitomycin C can delay the onset airway restenosis and improve quality of life for patients.The average diameter of the airways [WMD = 1.73,95% CI(0.13,0.13);z = 2.12,P = 0.034 < 0.05].The average added value of the diameter of the airways [WMD = 2.60,95% CI(1.20,1.20);z = 3.64,P = 0.000 < 0.05] Both of them had obviously increased.Dyspnea index [WMD = 1.137,95% CI(1.717,0.556);z = 3.84,P = 0.000 < 0.05].Dyspnea index had previous fall from before.Contrastive analysis animal model tests show that the application of mitomycin C treatment group and the application of physiological saline group has substantial improvement of the degree of airway stenosis[WMD = 33.65,95% CI(4.58,4.58);z = 2.27,P = 0.023 < 0.05].Conclusions: Available limited data show that mitomycin C has a certain role to prevent airway restenosis.Mitomycin C can't prevent the occurrence of airway restenosis,but it can delay the timing of restenosis.Studies didn't show the side effects of mitomycin C so far.So the application is safe.The specific applied concentration can't make a right evaluation temporarily.