Citations 2
Esophageal motility disorders on high‐resolution manometry: Chicago classification version 4.0 ©
Yadlapati, Rena , Fox, Mark , Bredenoord, Albert J. , Gyawali, C. Prakash , Roman, Sabine , Babaei, Arash , Mittal, Ravinder K. , Rommel, Nathalie , Savarino, Edoardo , Smout, A. J. P. M. , Vaezi, Michael F. , Akiyama, Junichi, Bhatia, Shobna , Carlson, Dustin A. , Chen, Joan W. , Cisternas, Daniel , Cock, Charles , Defilippi, Claudia, Gonlachanvit, Sutep , Hebbard, Geoffrey , Jung, Kee Wook , Katz, Philip O. , Katzka, David A. , Khan, Anzalee , Kohn, Geoffrey P. , Lazarescu, Adriana , Lengliner, Johannes, Omari, Taher , Pohl, Daniel , Richter, Joel E. , Serra, Jordi , Sweis, Rami , Tack, Jan , Tatum, Roger P. , Vela, Marcelo F. , Wu, Justin C. Y. , Xiao, Yinglian , Pandolfino, John E. , Fox, Mark R , Gyawali, C P , Roman, S , Babaei, Arash , Mittal, Ravinder K , Sifrim, Daniel , Smout, André , Zerbib, Frank , Bor, Serhat , Carlson, Dustin A , Cisternas, Daniel , Cock, Charles , de Bortoli, Nicola , Fass, Ronnie , Ghoshal, Uday C , Jung, Kee Wook , Khan, Abraham , Omari, Taher , Park, Moo In , Penagini, Roberto , Serra, Jordi , Tack, Jan , Savarino, Edoardo , Kahrilas, Peter J. , Bor, Serhat , Coss‐Adame, Enrique , Bortoli, Nicola de , Fass, Ronnie , Ghoshal, Uday C. , Hani, Albis Cecilia , Mittal, Sumeet K. , Penagini, Roberto , Tutuian, Radu I. , Wong, Reuben K.
Neurogastroenterology & Motility | December 29, 2020 | Volume: 33 | Issue: 1 | Pages: No page available
Abstract Chicago Classification v4.0 (CCv4.0) is the updated classification scheme for esophageal motility disorders using metrics from high‐resolution manometry (HRM). Fifty‐two diverse international experts separated into seven working subgroups utilized formal validated methodologies over two‐years to develop CCv4.0. Key updates in CCv.4.0 consist of a more rigorous and expansive HRM protocol that incorporates supine and upright test positions as well as provocative testing, a refined definition of esophagogastric junction (EGJ) outflow obstruction (EGJOO), more stringent diagnostic criteria for ineffective esophageal motility and description of baseline EGJ metrics. Further, the CCv4.0 sought to define motility disorder diagnoses as conclusive and inconclusive based on associated symptoms, and findings on provocative testing as well as supportive testing with barium esophagram with tablet and/or functional lumen imaging probe. These changes attempt to minimize ambiguity in prior iterations of Chicago Classification and provide more standardized and rigorous criteria for patterns of disorders of peristalsis and obstruction at the EGJ.
How to select patients for antireflux surgery? The ICARUS guidelines (international consensus regarding preoperative examinations and clinical characteristics assessment to select adult patients for antireflux surgery)
Pauwels, Ans, Andrews, Christopher N. , Attwood, Stephen , Berrisford, Richard, Bisschops, Raf , Boeckxstaens, Guy E. , Bor, Serhat , Bredenoord, Albert J. , Cicala, Michele , Corsetti, Maura , Fornari, Fernando , Gyawali, C. Prakash , Hatlebakk, Jan, Johnson, Scott, Lerut, Toni, Lundell, Lars, Mattioli, Sandro , Omari, Taher , Pandolfino, John E. , Penagini, Roberto , Rice, Thomas W., Roelandt, Philip , Rommel, Nathalie , Savarino, Vincenzo , Vanuytsel, Tim , Vela, Marcelo F. , Watson, David I. , Tack, Jan , Lerut, Antoon , Tack, Jan , Gyawali, C P , Corsetti, M , Penagini, Roberto , Bisschops, Raf , Bor, Serhat , Omari, Taher , Boeckxstaens, Guy , Andrews, Christopher N , Boecxstaens, Veerle , Miwa, Hiroto , Nafteux, Philippe Robert , Sifrim, Daniel , Suzuki, Hidekazu , Tutuian, Radu I. , Zerbib, Frank
Gut | August 2, 2019 | Volume: 68 | Issue: 11 | Pages: 1928-1941
Objective Antireflux surgery can be proposed in patients with GORD, especially when proton pump inhibitor (PPI) use leads to incomplete symptom improvement. However, to date, international consensus guidelines on the clinical criteria and additional technical examinations used in patient selection for antireflux surgery are lacking. We aimed at generating key recommendations in the selection of patients for antireflux surgery. Design We included 35 international experts (gastroenterologists, surgeons and physiologists) in a Delphi process and developed 37 statements that were revised by the Consensus Group, to start the Delphi process. Three voting rounds followed where each statement was presented with the evidence summary. The panel indicated the degree of agreement for the statement. When 80% of the Consensus Group agreed (A+/A) with a statement, this was defined as consensus. All votes were mutually anonymous. Results Patients with heartburn with a satisfactory response to PPIs, patients with a hiatal hernia (HH), patients with oesophagitis Los Angeles (LA) grade B or higher and patients with Barrett’s oesophagus are good candidates for antireflux surgery. An endoscopy prior to antireflux surgery is mandatory and a barium swallow should be performed in patients with suspicion of a HH or short oesophagus. Oesophageal manometry is mandatory to rule out major motility disorders. Finally, oesophageal pH (±impedance) monitoring of PPI is mandatory to select patients for antireflux surgery, if endoscopy is negative for unequivocal reflux oesophagitis. Conclusion With the ICARUS guidelines, we generated key recommendations for selection of patients for antireflux surgery.