Our new Esophageal Clinic, an integrated diagnostic structure shortens decision-making time and reduces resource utilization and cost

Abstract Introduction Over the past year, we established and trialed a new Surgical Esophageal Clinic at Örebro University Hospital. By integrating outpatient surgical consultation with endoscopy and EndoFLIP motility assessment, we have shortened diagnostic lead times, improved diagnostic precision, and reduced resource utilization in the evaluation of esophageal pathology. Method Patients referred for esophageal symptoms (e.g., dysphagia, reflux, regurgitation) are now scheduled for a 60-minute consultant visit. After history taking, a sedated gastroscopy (diazepam/propofol) and EndoFLIP motility assessment are performed in the same session. When additional investigations are needed (e.g., radiology, HRM), referrals are made with improved specificity. pH-metry probes are placed when indicated. Joint assessment with a gastroenterologist and endoscopic ultrasound may be added. Soon, we will also introduce goal-directed dilatation (EsoFLIP) during the same session if required. Result The median time from first visit to decision-making was 160 days (range 68–270, n = 9) using the traditional method, compared to 16 days (range 0–20, n = 6) with the new approach (p < 0.05). All these visits where complex benign esophageal cases. The median number of hospital visits before surgery was reduced from 3 (range 2–5) to 1 (range 1–2) (p < 0.05). Discussion This integrated clinical model significantly reduces diagnostic delays and hospital visits, potentially improving both efficiency and diagnostic quality. Further studies are planned.