TY - JOUR T1 - Kyoto international consensus report on anatomy, pathophysiology and clinical significance of the gastro-oesophageal junction JF - Gut JO - Gut SP - 1488 LP - 1514 DO - 10.1136/gutjnl-2022-327281 VL - 71 IS - 8 AU - Kentaro Sugano AU - Stuart Jon Spechler AU - Emad M El-Omar AU - Kenneth E L McColl AU - Kaiyo Takubo AU - Takuji Gotoda AU - Mitsuhiro Fujishiro AU - Katsunori Iijima AU - Haruhiro Inoue AU - Takashi Kawai AU - Yoshikazu Kinoshita AU - Hiroto Miwa AU - Ken-ichi Mukaisho AU - Kazunari Murakami AU - Yasuyuki Seto AU - Hisao Tajiri AU - Shobna Bhatia AU - Myung-Gyu Choi AU - Rebecca C Fitzgerald AU - Kwong Ming Fock AU - Khean-Lee Goh AU - Khek Yu Ho AU - Varocha Mahachai AU - Maria O'Donovan AU - Robert Odze AU - Richard Peek AU - Massimo Rugge AU - Prateek Sharma AU - Jose D Sollano AU - Michael Vieth AU - Justin Wu AU - Ming-Shiang Wu AU - Duowu Zou AU - Michio Kaminishi AU - Peter Malfertheiner Y1 - 2022/08/01 UR - http://gut.bmj.com/content/71/8/1488.abstract 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. ER -