RT Journal Article
SR Electronic
T1 Kyoto international consensus report on anatomy, pathophysiology and clinical significance of the gastro-oesophageal junction
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP 1488
OP 1514
DO 10.1136/gutjnl-2022-327281
VO 71
IS 8
A1 Sugano, Kentaro
A1 Spechler, Stuart Jon
A1 El-Omar, Emad M
A1 McColl, Kenneth E L
A1 Takubo, Kaiyo
A1 Gotoda, Takuji
A1 Fujishiro, Mitsuhiro
A1 Iijima, Katsunori
A1 Inoue, Haruhiro
A1 Kawai, Takashi
A1 Kinoshita, Yoshikazu
A1 Miwa, Hiroto
A1 Mukaisho, Ken-ichi
A1 Murakami, Kazunari
A1 Seto, Yasuyuki
A1 Tajiri, Hisao
A1 Bhatia, Shobna
A1 Choi, Myung-Gyu
A1 Fitzgerald, Rebecca C
A1 Fock, Kwong Ming
A1 Goh, Khean-Lee
A1 Ho, Khek Yu
A1 Mahachai, Varocha
A1 O'Donovan, Maria
A1 Odze, Robert
A1 Peek, Richard
A1 Rugge, Massimo
A1 Sharma, Prateek
A1 Sollano, Jose D
A1 Vieth, Michael
A1 Wu, Justin
A1 Wu, Ming-Shiang
A1 Zou, Duowu
A1 Kaminishi, Michio
A1 Malfertheiner, Peter
YR 2022
UL http://gut.bmj.com/content/71/8/1488.abstract
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.