Rules Are Meant to Be Broken: Examining the "Rule of 3" for Esophageal Dilations in Pediatric Stricture Patients

Retrospective study of 1,384 pediatric esophageal dilations challenges the traditional 'rule of 3' guideline, finding that balloon dilations up to 5mm beyond initial stricture diameter maintain acceptable perforation risk (0.74% vs 4.85% for >5mm). Data suggests a potential new 'rule of 5' may be safer and more effective for pediatric stricture management.