The Italian validation of the Montreal Global definition and classification of gastroesophageal reflux disease

Pace, F.; Bazzoli, Franco; Fiocca, Roberto; Mario, F. Di; Savarino, Vincenzo; Vigneri, Sergio; Vakil, Nimish

doi:10.1097/meg.0b013e32830a70e2

Cited by 13 publications

(5 citation statements)

References 130 publications

(185 reference statements)

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“…More recently, based on evidence that BE-CM is also prone to cancerization, the definition of BE has come to include cardiac-type columnar metaplasia once again [5,6]. The (controversial) definition of Barrett disease not only carries biological implications but also influences which patients need to be followed up as part of any BAc secondary prevention strategy [7].…”

Section: Introductionmentioning

confidence: 99%

Anterior gradient 2 profiling in Barrett columnar epithelia and adenocarcinoma

et al. 2012

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Section: Introductionmentioning

confidence: 99%

Anterior gradient 2 profiling in Barrett columnar epithelia and adenocarcinoma

et al. 2012

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“…Typical esophageal symptoms include: heartburn (retrosternal burning sensation), regurgitation (perception of flow of refluxed gastric content in the mouth or hypopharynx) and epigastric/chest pain, sometimes indistinguishable from ischemic cardiac pain. Chronic cough, laryngitis, asthma and dental erosion are the more frequently reported extra-esophageal symptoms 4 , 5 .…”

Section: Gastro-esophageal Reflux Disease (Gerd)mentioning

confidence: 99%

Gastro-esophageal reflux disease and Barrett’s esophagus: an overview with an histologic diagnostic approach

et al. 2020

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Summary The first part of this overview on non-neoplastic esophagus is focused on gastro-esophageal reflux disease (GERD) and Barrett’s esophagus. In the last 20 years much has changed in histological approach to biopsies of patients with gastro-esophageal reflux disease. In particular, elementary histologic lesions have been well defined and modality of evaluation and grade are detailed, their sensitivity and specificity has been evaluated and their use has been validated by several authors. Also if there is not a clinical indication to perform biopsies in patient with GERD, the diagnosis of microscopic esophagitis, when biopsies are provided, can be performed by following simple rules for evaluation which allow pathologists to make the diagnosis with confidence. On the other hand, biopsies are required for the diagnosis of Barrett’s esophagus. This diagnosis is the synthesis of endoscopic picture (which has to be provided with the proper description on extent and with adequate biopsies number) and histologic pattern. The current guidelines and expert opinions for the correct management of these diagnosis are detailed.

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Section: Introductionmentioning

confidence: 99%

“…Gastroesophageal reflux disease (GERD) is a highly prevalent condition among patients presenting in the ambulatory setting and develops when gastric contents move retrograde from the stomach into the esophagus [1,2]. According to the Montreal consensus, GERD develops when this reflux of stomach contents results in troublesome symptoms or complications [3][4][5]. While some reflux is physiologic, symptoms of heartburn or regurgitation have been reported to occur in approximately Transoral incisionless fundoplication is cost-effective for treatment of gastroesophageal reflux disease Patients and methods A deterministic Markov cohort model was constructed from the US healthcare payer's perspective to evaluate the cost-effectiveness of three competing strategies: 1) omeprazole 20 mg twice daily; 2) transoral incisionless fundoplication (TIF 2.0); and 3) laparoscopic Nissen fundoplication [LNF].…”

Section: Introductionmentioning

confidence: 99%

Transoral incisionless fundoplication is cost-effective for treatment of gastroesophageal reflux disease

et al. 2022

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Background and study aims Given the sizable number of patients with symptomatic gastroesophageal reflux disease (GERD) despite proton pump inhibitor (PPI) therapy, non-pharmacologic treatment has become increasingly utilized. The aim of this study was to analyze the cost-effectiveness of medical, endoscopic, and surgical treatment of GERD. Patients and methods A deterministic Markov cohort model was constructed from the US healthcare payer’s perspective to evaluate the cost-effectiveness of three competing strategies: 1) omeprazole 20 mg twice daily; 2) transoral incisionless fundoplication (TIF 2.0); and 3) laparoscopic Nissen fundoplication [LNF]. Cost was reported in US dollars with health outcomes recorded in quality-adjusted life years (QALYs). Ten-year and lifetime time horizons were utilized with 3 % discount rate and half-cycle corrections applied. The main outcome was incremental cost-effectiveness ratio (ICER) with a willingness-to-pay threshold of $ 100,000 per QALY. Probabilistic sensitivity analyses were also performed. Results In our base-case analysis, the average cost of TIF 2.0 was $ 13,978.63 versus $ 17,658.47 for LNF and $ 10,931.49 for PPI. Compared to the PPI strategy, TIF 2.0 was cost-effective with an incremental cost of $ 3,047 and incremental effectiveness of 0.29 QALYs, resulting in an ICER of $ 10,423.17 /QALY gained. LNF was strongly dominated by TIF 2.0. Over a lifetime horizon, TIF 2.0 remained the cost-effective strategy for patients with symptoms despite twice-daily 20-mg omeprazole. TIF 2.0 remained cost-effective after varying parameter inputs in deterministic and probabilistic sensitivity analyses and for scenario analyses in multiple age groups. Conclusions Based upon this study, TIF 2.0 was cost-effective for patients with symptomatic GERD despite low-dose, twice-daily PPI.

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The Italian validation of the Montreal Global definition and classification of gastroesophageal reflux disease

Cited by 13 publications

References 130 publications

Anterior gradient 2 profiling in Barrett columnar epithelia and adenocarcinoma

Anterior gradient 2 profiling in Barrett columnar epithelia and adenocarcinoma

Gastro-esophageal reflux disease and Barrett’s esophagus: an overview with an histologic diagnostic approach

Transoral incisionless fundoplication is cost-effective for treatment of gastroesophageal reflux disease

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