S2171 Esophageal Dilation for Benign Strictures: A Comparative Study of Outcomes and Practice Patterns Between General and Advanced Endoscopists

Introduction: Esophageal dilation is a critical intervention for benign strictures causing dysphagia. Limited data currently exists comparing clinical outcomes and procedural details and technicalities between general and advanced endoscopists. The purpose of this study was to compare outcomes, procedural metrics, and adverse event rates. Methods: We conducted a retrospective cohort study of all patients undergoing esophageal dilation for benign strictures at a tertiary care center over 15 years. Clinical success was determined as sustained dysphagia relief 6 months following dilation, while remission was defined as recurrence of dysphagia after achieving clinical success. Key variables included initial lumen diameter, average change in diameter (delta) per session, total change in diameter from the first to last session, number of sessions required for clinical success, adverse events, and clinical remission. Statistical analyses were performed to identify differences between groups. Results: Eighty patients were included in the study, with 50 patients treated by general endoscopists and 30 patients by advanced endoscopists. Of the total cohort, 48 were man, and 32 were woman. Patients treated by advanced endoscopists had a significantly smaller initial lumen diameter (7.8 ± 3.2 mm) compared to those treated by general endoscopists (10.8 ± 3.7 mm, P = 0.001). The total change in diameter from the first to last session trended higher in the advanced group (5.16 ± 2.67 mm vs 4.04 ± 2.38 mm, P = 0.052). The average number of sessions required for clinical success was 2.43 in the advanced group and 2.28 in the general group (P = 0.064). The average change in diameter per session was similar (3.76 ± 2.18 mm vs 3.09 ± 1.39 mm, P = 0.2). Clinical success was achieved in 70% of patients in the advanced group and 72% in the general group (P = 0.8). Remission rates were 64% in the advanced group and 48% in the general group (P = 0.2). Adverse event rates were comparable between groups (P = 0.4). Conclusion: Initial luminal diameter varied by provider type, with advanced endoscopists more frequently managing narrower strictures. Despite this, both groups demonstrated similar clinical success, remission, and safety outcomes. These findings highlight comparable efficacy and safety profiles across provider types while reflecting potential differences in case selection.