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Although endoscopic dilation of esophageal strictures in patients with eosinophilic esophagitis (EoE) is a mainstay of treatment, significant mucosal disruption (sometimes with long, deep, linear mucosal tears) typically raises concern over increased risk for adverse events.
In the current systematic review and random-effects meta-analysis, researchers evaluated 37 studies comprising 2000 dilations on nearly 1000 patients. Only one study was a randomized trial, and most did not evaluate adverse events as the primary outcome. No studies were at low risk for bias.
The cumulative perforation rate was low (0.03%) and comparable to the rate for esophageal dilation in other benign diseases. The perforation rate was higher among studies published be…