Kyoto international consensus report on anatomy, pathophysiology and clinical significance of the gastro-oesophageal junction

Sugano K, Spechler SJ, El-Omar EM, Mccoll KEL, Takubo K, Gotoda T, Fujishiro M, Iijima K, Inoue H, Kawai T, Kinoshita Y, Miwa H, Mukaisho KI, Murakami K, Seto Y, Tajiri H, Bhatia S, Choi MG, Fitzgerald RC, Fock KM, Goh KL, Ho KY, Mahachai V, O'Donovan M, Odze R, Peek R, Rugge M, Sharma P, Sollano JD, Vieth M, Wu J, Wu MS, Zou D, Kaminishi M, Malfertheiner P (2022)

Publication Type: Journal article, Review article

Publication year: 2022

Journal

Book Volume: 71

Pages Range: 1488-1514

Journal Issue: 8

DOI: 10.1136/gutjnl-2022-327281

Abstract

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.

Authors with CRIS profile

Involved external institutions

Jichi Medical University / 自治医科大学 Japan (JP) Baylor University (BU) United States (USA) (US) St George and Sutherland Clinical School Australia (AU) University of Glasgow United Kingdom (GB) Tokyo Metropolitan Institute of Gerontology Japan (JP) Nihon University / 日本大学 Japan (JP) University of Tokyo Japan (JP) Akita University / 秋田大学 Japan (JP) Showa University Hospitals Japan (JP) Tokyo Medical and Dental University (TMDU) / 東京医科歯科大学 Japan (JP) Hyogo Prefectural Harima-Himeji General Medical Center Japan (JP) Hyogo College of Medicine Japan (JP) Shiga University of Medical Science Japan (JP) The Chinese University of Hong Kong (CUHK) China (CN) Oita University / 大分大学 Japan (JP) Jikei University School of Medicine / 東京慈恵会医科大学 Japan (JP) Sir H. N. Reliance Foundation Hospital and Research Centre India (IN) Catholic University of Korea Korea, Republic of (KR) University of Cambridge United Kingdom (GB) National University of Singapore (NUS) Singapore (SG) University of Malaya (UM) / Universiti Malaya Malaysia (MY) Thammasat University / มหาวิทยาลัยธรรมศาสตร์ Thailand (TH) Tufts University United States (USA) (US) Vanderbilt University United States (USA) (US) University of Padua / Universita degli Studi di Padova Italy (IT) University of Kansas (KU) United States (USA) (US) University of Santo Tomas Hospital Philippines (PH) National Taiwan University Hospital (NTUH) / 國立台灣大學醫學院附設醫院 Taiwan (TW) Shanghai Jiao Tong University / 上海交通大学 China (CN) Universitätsklinikum der Ludwig-Maximilians-Universität München Germany (DE) Cambridge University Hospital United Kingdom (GB)

How to cite

APA:

Sugano, K., Spechler, S.J., El-Omar, E.M., Mccoll, K.E.L., Takubo, K., Gotoda, T.,... Malfertheiner, P. (2022). Kyoto international consensus report on anatomy, pathophysiology and clinical significance of the gastro-oesophageal junction. Gut, 71(8), 1488-1514. https://dx.doi.org/10.1136/gutjnl-2022-327281

MLA:

Sugano, Kentaro, et al. "Kyoto international consensus report on anatomy, pathophysiology and clinical significance of the gastro-oesophageal junction." Gut 71.8 (2022): 1488-1514.

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