Esophageal dilation: personal experience with current instruments and techniques

The popularity and widespread use of flexible panendoscopy has produced a dramatic change in the management of benign strictures of the esophagus. Most are now managed medically. Two new esophageal dilators, the balloon and Savary, have made a major impact on the endoscopist's armamentarium. The Maloney dilator is still used 56% of the time, in the author's experience with strictures that are symmetrical and greater than 1.2-1.4 cm in diameter. Hydrostatic balloon dilators are used 24% of the time with strictures that are asymmetrical and 1.2 cm or more in diameter. The Savary thermoplastic dilators have replaced Eder-Puestow dilators and are used 20% of the time in strictures 1.2 cm or less in diameter. Morbidity and mortality rates should be under 1% with all dilators and are 0.1% and 0.05%, respectively, in the author's last 2000 dilations.