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 Kentaro Sugano
A1 Stuart Jon Spechler
A1 Emad M El-Omar
A1 Kenneth E L McColl
A1 Kaiyo Takubo
A1 Takuji Gotoda
A1 Mitsuhiro Fujishiro
A1 Katsunori Iijima
A1 Haruhiro Inoue
A1 Takashi Kawai
A1 Yoshikazu Kinoshita
A1 Hiroto Miwa
A1 Ken-ichi Mukaisho
A1 Kazunari Murakami
A1 Yasuyuki Seto
A1 Hisao Tajiri
A1 Shobna Bhatia
A1 Myung-Gyu Choi
A1 Rebecca C Fitzgerald
A1 Kwong Ming Fock
A1 Khean-Lee Goh
A1 Khek Yu Ho
A1 Varocha Mahachai
A1 Maria O'Donovan
A1 Robert Odze
A1 Richard Peek
A1 Massimo Rugge
A1 Prateek Sharma
A1 Jose D Sollano
A1 Michael Vieth
A1 Justin Wu
A1 Ming-Shiang Wu
A1 Duowu Zou
A1 Michio Kaminishi
A1 Peter Malfertheiner
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.