TY - JOUR
T1 - Kyoto international consensus report on anatomy, pathophysiology and clinical significance of the gastro-oesophageal junction
AU - Sugano, Kentaro
AU - Spechler, Stuart Jon
AU - El-Omar, Emad M.
AU - McColl, Kenneth E.L.
AU - Takubo, Kaiyo
AU - Gotoda, Takuji
AU - Fujishiro, Mitsuhiro
AU - Iijima, Katsunori
AU - Inoue, Haruhiro
AU - Kawai, Takashi
AU - Kinoshita, Yoshikazu
AU - Miwa, Hiroto
AU - Mukaisho, Ken Ichi
AU - Murakami, Kazunari
AU - Seto, Yasuyuki
AU - Tajiri, Hisao
AU - Bhatia, Shobna
AU - Choi, Myung Gyu
AU - Fitzgerald, Rebecca C.
AU - Fock, Kwong Ming
AU - Goh, Khean Lee
AU - Ho, Khek Yu
AU - Mahachai, Varocha
AU - O'Donovan, Maria
AU - Odze, Robert
AU - Peek, Richard
AU - Rugge, Massimo
AU - Sharma, Prateek
AU - Sollano, Jose D.
AU - Vieth, Michael
AU - Wu, Justin
AU - Wu, Ming Shiang
AU - Zou, Duowu
AU - Kaminishi, Michio
AU - Malfertheiner, Peter
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2022.
PY - 2022/8/1
Y1 - 2022/8/1
N2 - Objective An international meeting was organised to develop consensus on (1) the landmarks to define the gastro-oesophageal junction (GOJ), (2) the occurrence and pathophysiological significance of the cardiac gland, (3) the definition of the gastro-oesophageal junctional zone (GOJZ) and (4) the causes of inflammation, metaplasia and neoplasia occurring in the GOJZ. Design Clinical questions relevant to the afore-mentioned major issues were drafted for which expert panels formulated relevant statements and textural explanations. A Delphi method using an anonymous system was employed to develop the consensus, the level of which was predefined as ≥80% of agreement. Two rounds of voting and amendments were completed before the meeting at which clinical questions and consensus were finalised. Results Twenty eight clinical questions and statements were finalised after extensive amendments. Critical consensus was achieved: (1) definition for the GOJ, (2) definition of the GOJZ spanning 1 cm proximal and distal to the GOJ as defined by the end of palisade vessels was accepted based on the anatomical distribution of cardiac type gland, (3) chemical and bacterial (Helicobacter pylori) factors as the primary causes of inflammation, metaplasia and neoplasia occurring in the GOJZ, (4) a new definition of Barrett's oesophagus (BO). Conclusions This international consensus on the new definitions of BO, GOJ and the GOJZ will be instrumental in future studies aiming to resolve many issues on this important anatomic area and hopefully will lead to better classification and management of the diseases surrounding the GOJ.
AB - Objective An international meeting was organised to develop consensus on (1) the landmarks to define the gastro-oesophageal junction (GOJ), (2) the occurrence and pathophysiological significance of the cardiac gland, (3) the definition of the gastro-oesophageal junctional zone (GOJZ) and (4) the causes of inflammation, metaplasia and neoplasia occurring in the GOJZ. Design Clinical questions relevant to the afore-mentioned major issues were drafted for which expert panels formulated relevant statements and textural explanations. A Delphi method using an anonymous system was employed to develop the consensus, the level of which was predefined as ≥80% of agreement. Two rounds of voting and amendments were completed before the meeting at which clinical questions and consensus were finalised. Results Twenty eight clinical questions and statements were finalised after extensive amendments. Critical consensus was achieved: (1) definition for the GOJ, (2) definition of the GOJZ spanning 1 cm proximal and distal to the GOJ as defined by the end of palisade vessels was accepted based on the anatomical distribution of cardiac type gland, (3) chemical and bacterial (Helicobacter pylori) factors as the primary causes of inflammation, metaplasia and neoplasia occurring in the GOJZ, (4) a new definition of Barrett's oesophagus (BO). Conclusions This international consensus on the new definitions of BO, GOJ and the GOJZ will be instrumental in future studies aiming to resolve many issues on this important anatomic area and hopefully will lead to better classification and management of the diseases surrounding the GOJ.
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U2 - 10.1136/gutjnl-2022-327281
DO - 10.1136/gutjnl-2022-327281
M3 - Review article
C2 - 35725291
AN - SCOPUS:85134361228
SN - 0017-5749
VL - 71
SP - 1488
EP - 1514
JO - Gut
JF - Gut
IS - 8
ER -