Endoscopic balloon dilation (EBD) is the standard endoscopic treatment for Crohn’s disease strictures, but recurrence and repeated interventions remain important challenges. The BEST-CD randomized controlled trial evaluated whether endoscopic stricturotomy (ES) could improve outcomes in patients with short strictures. Of 164 patients screened, 106 adults aged 18–65 years with symptomatic CD and strictures shorter than 3 cm were randomized to ES (n=53) or EBD (n=53). In the intention-to-treat analysis, 1-year clinical recurrence was significantly lower with ES than EBD (30.1% vs. 54.7%; p=0.01). ES also reduced reintervention (24.5% vs.

49.1%; p=0.01), stricture-related emergency visits (18.9% vs. 50.9%; p=0.001), and hospitalizations (15.1% vs. 34%; p=0.02). Surgery rates did not differ significantly (1.9% vs. 11.3%; p=0.11). Time-to-event analysis showed higher hazards with EBD for…