Diseases of the Esophagus最新文献

{"title":"Gastroesophageal vestibule and lower esophageal sphincter: the same thing.","authors":"Owen Korn, Juan C Oñate, Attila Csendes, Sebastian Sapiain, Tomas Gonzalez","doi":"10.1093/dote/doaf051","DOIUrl":"https://doi.org/10.1093/dote/doaf051","url":null,"abstract":"<p><strong>Background: </strong>The anatomic transition between the lower end of the esophagus and the stomach is complex. The tubular esophagus terminates as a bell-shaped structure called the gastroesophageal vestibule (GEV). The anatomy and physiology of this segment has been widely studied. However, there is no detailed description of its muscular architecture and its relationship with the muscular fibers of the lower esophageal sphincter (LES). Therefore, the purpose of the present study was to describe the muscular structure of the GEV and to establish its relationship with the LES.</p><p><strong>Material and method: </strong>Twenty human gastroesophageal specimens were obtained from fresh cadavers. The specimens were filled with water until reaching the maximal distension of the vestibule. The upper and lower limits were marked with stitches and their lengths and perimeters were measured. The specimens were opened and fixed in 10% formalin. The mucosa of the vestibule was stripped off, allowing fibers of internal muscular coat to be seen.</p><p><strong>Results: </strong>The length of the vestibule measured at the lesser curvature was 3.7 cm (3.0-6.5 cm), which was longer than at the greater curvature measuring 2.8 cm (2.0-4.5 cm). The perimeter of its base, on basal condition was 7.1 cm (6.0-8.5 cm) but it reached up to 11.6 cm (10.0-15.0 cm) when it was dilated. The Z-line is located at the union of the lower third with the middle third of the vestibule. The walls of the GV were formed by 'Clasp' fibers and oblique (Sling) fibers.</p><p><strong>Conclusions: </strong>The GEV is the only dilatable structure at the gastroesophageal junction, and it is formed by the muscular fibers of the LES. Therefore, the GEV corresponds to this sphincter.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of computed tomography and endoscopy in caustic esophageal injury in adults: a systematic review.","authors":"Elisa Bass, John Asher Jenkins, Juan M Farina, Andrew Saleeb, Staci E Beamer, Dawn E Jaroszewski, Samine Ravanbakhsh, Cecilia Benz, Pedro Reck Dos Santos, Jonathan D'Cunha","doi":"10.1093/dote/doaf037","DOIUrl":"https://doi.org/10.1093/dote/doaf037","url":null,"abstract":"<p><p>Caustic esophageal injury can cause severe morbidity and mortality. Despite the need for emergent treatment, individual experience in diagnosis and management can be limited. Computed tomography (CT) has emerged as a promising non-invasive modality for assessing injury severity, but the clinical utility of both CT and endoscopy should be investigated. A systematic review was conducted following PRISMA guidelines. A comprehensive search of the PubMed database identified relevant articles published from January 1, 2000 to December 31, 2023. Inclusion criteria encompassed studies investigating the use of CT and/or endoscopy in diagnosing and managing caustic esophageal injury. Twelve articles were selected from a pool of 931 studies. Findings suggested that CT was superior in diagnostic capability to endoscopy in high-grade injury and stricture formation, but less so for low grade injuries. Diagnostic algorithms incorporating imaging with laboratory studies have emerged in the literature, which are promising pending additional validation. CT can serve as a valuable, non-invasive tool in the initial evaluation of caustic esophageal injury and is postulated to accurately predict both the need for emergent surgery and the risk of stricture formation. However, CT should not replace but rather complement the use of endoscopy to comprehensively evaluate these potentially highly morbid situations.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calculating the minimally important difference for the FACT-E from esophageal cancer surgery to recovery using distribution-based methods.","authors":"Trafford Crump, Mehrnoush Dehghani, Jason M Sutherland, Carmen Mueller, Lorenzo Edwin Ferri","doi":"10.1093/dote/doaf042","DOIUrl":"10.1093/dote/doaf042","url":null,"abstract":"<p><p>A challenge with patient-reported outcomes is interpreting changes in scores. The minimally important difference (MID) represents the smallest meaningful change in a score. This study's objective is to calculate the MID for the Functional Assessment of Cancer Therapy-Esophageal (FACT-E) and examine whether the MID changes over time from treatment through recovery. This retrospective longitudinal study analyzed data from the McGill University Esophageal and Gastric Data- and Bio-Bank. Participants were adults who underwent esophageal cancer surgery and completed the FACT-E pre-surgery and at least once post-surgery. MIDs were calculated using two distribution-based approaches: standard deviation and standard error of measurement. MIDs were calculated for the five FACT-E domains and total score at multiple time points. The study included 676 participants. MIDs varied by domain and calculation method. The MIDs ranged from 1 to 3 points for most domains, 2 to 5 points for the esophagus cancer subscale, and 4 to 9 points for the FACT-E total score. The MIDs changed over time, with the greatest fluctuations found in the esophagus cancer subscale. This study provides the first estimates of MIDs for the FACT-E, offering clinicians and researchers guidance for interpreting meaningful changes in scores. The range of MIDs can help identify potentially important changes in patient-reported symptoms and quality of life over time. Further studies using additional methods to calculate MIDs are warranted to refine these estimates.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of gastroesophageal reflux disease revisited: a novel gastroesophageal reflux disease clinical prediction score.","authors":"Lea Fayad, Ethan Gough, Antonio Almario, Mohamad Dbouk, Elizabeth Abou Diwan, Marcia Irene Canto","doi":"10.1093/dote/doaf046","DOIUrl":"https://doi.org/10.1093/dote/doaf046","url":null,"abstract":"<p><p>Symptom assessment and proton pump inhibitor (PPI) trial are limited in predicting pathologic gastroesophageal reflux disease (GERD) on pH testing and endoscopy, which has led to PPI overuse. We aimed to develop a novel scoring system using demographic factors, clinical factors, and symptoms to predict pathologic GERD. Adult patients with GERD were prospectively enrolled into a Heartburn Center Registry from April 2019 to September 2021. Demographics, patient responses to validated questionnaires, results of endoscopy and pH testing were collected. We selected variables associated with pathologic GERD (P < 0.10) in bivariable analyses for inclusion in multivariable models to predict pathologic GERD. A total of 365 patients were included. About 199/365 (33%) of these patients had pathologic GERD based on abnormal pH testing (49.7%) and/or abnormal esophagogastroduodenoscopy (EGD) (61.3%). Our clinical prediction model included 10 variables and had a sensitivity of 90%, specificity of 56%, and area under the receiver operator characteristic curve (AUROC) 0.77, and was then validated using a separate cohort. The model was then refitted using the expanded criteria for definition of GERD from the new Lyon Consensus 2.0. Four new variables led to improved model performance including history of chronic lung disease, history of asthma, history of gastroparesis and heartburn after meals. This expanded model including 14 variables had a sensitivity of 84.2%, specificity of 71.7%, and AUROC of 0.80, which was then validated in a separate cohort. Our novel 10-variable GERD prediction model performs well for estimating risk for pathologic GERD without invasive testing and is potentially a practical clinical screening tool for pathologic GERD.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of hiatus hernia classifications.","authors":"O A Barratt, T Badenoch, J M Findlay","doi":"10.1093/dote/doaf044","DOIUrl":"https://doi.org/10.1093/dote/doaf044","url":null,"abstract":"<p><p>Hiatus hernias (HH) are common and significantly impact symptoms and morbidity in Upper GI surgery, yet there is no consensus on classification. We previously identified various classification systems used in randomized trials, but these often lack clinical relevance. This inconsistency affects benchmarking, standardizing practice, and the ability to generate and answer research questions effectively. The aim of this review was to systematically identify and appraise what classification systems have been described and their association with treatment outcomes. We undertook a systematic review of the PubMed and EMBASE databases on the 17th January 2023. A total of 847 articles were identified and 304 were included, with a further 10 studies identified that tested a novel approach to classifying HH against surgical outcomes. The commonest method of classifying HH in the literature was Types I-IV used in 60% of studies. Other studies described endoscopic, manometric, anti-reflux, intraoperative, and postoperative classifications. Eighteen separate definitions were recorded for oversized HH; described as Massive, Giant, or Large. The quality of studies linking classifications to outcomes was limited, but some associations were noted based on anatomical and physiological factors. Types I-IV are the most common method of classifying HH in the literature. There was significant and overlap and discrepancy in the definitions used for Massive, Giant, and Large HH. Although evidence is limited, components such as intra-thoracic stomach or hiatal dimensions may improve HH classification and guide treatment, standardization, and research.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence patterns following neoadjuvant chemotherapy combined with immunotherapy for esophageal squamous cell carcinoma.","authors":"Miao Wang, Xinyi Wang, Zhourong Liu, Haixia Shen, Baojia Qi, Min Fang, Jin Wang, Yongling Ji, Jian Zeng","doi":"10.1093/dote/doaf034","DOIUrl":"https://doi.org/10.1093/dote/doaf034","url":null,"abstract":"<p><p>This study aims to examine the recurrence patterns in patients with locally advanced esophageal squamous cell carcinoma who underwent surgery following neoadjuvant chemotherapy combined with immunotherapy. Retrospective analysis of patients with esophageal squamous cell carcinoma who received neoadjuvant Chemo-IO before surgery at Zhejiang Cancer Hospital between 2019 and 2023. The clinicopathological features, recurrence patterns, overall survival (OS), and disease-free survival (DFS) were analyzed, and the impact of postoperative adjuvant radiotherapy on prognosis was evaluated. In total, 422 patients were included in the study. After a median follow-up of 22 months, disease recurrence was observed in 89 (21.1%) patients, comprising 37 cases (8.8%) of locoregional recurrence, 30 cases (7.1%) of distant metastasis, and 22 cases (5.2%) of combined recurrence. Patients who achieved a pathologic complete response demonstrated significantly higher 3-year OS rates (90.0% vs. 72.5%; P = 0.01) and DFS rates (73.2% vs. 61.8%; P = 0.046). Univariable and multivariable analyses identified pathological lymph node staging (ypN0 vs. ypN+; HR: 1.73; 95% CI: 1.01-2.99; P = 0.047) as an independent prognostic factor for locoregional recurrence. Kaplan-Meier curves for OS and DFS demonstrated that postoperative radiotherapy (PORT) significantly improved OS and DFS in ypN+ patients after propensity score matching. Additionally, PORT significantly enhanced locoregional recurrence-free survival and distant recurrence-free survival in ypN+ patients. In patients receiving neoadjuvant Chemo-IO, locoregional recurrence is the predominant recurrence pattern. For ypN+ patients, PORT significantly improved survival outcomes. However, long-term outcomes require further investigation through randomized controlled trials.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of pembrolizumab plus chemotherapy for postoperative recurrent esophageal squamous cell carcinoma.","authors":"Takahito Sugase, Takashi Kanemura, Norihiro Matsuura, Keijiro Sugimura, Tomohira Takeoka, Yuki Ushimaru, Yasunori Masuike, Yoshitomo Yanagimoto, Ryota Mori, Masatoshi Kitakaze, Masahiko Kubo, Yosuke Mukai, Hisateru Komatsu, Toshinori Sueda, Yoshinori Kagawa, Junichi Nishimura, Hiroshi Wada, Masayoshi Yasui, Hiroshi Miyata","doi":"10.1093/dote/doaf029","DOIUrl":"https://doi.org/10.1093/dote/doaf029","url":null,"abstract":"<p><strong>Background: </strong>Immunotherapy combined with chemotherapy has been the first-line treatment for metastatic or unresectable locally advanced esophageal cancer. However, postoperative recurrences have not been sufficiently investigated. We investigated the clinical outcomes of pembrolizumab plus cisplatin plus 5-fluorouracil (CF) therapy for postoperative recurrent esophageal squamous cell carcinoma.</p><p><strong>Methods: </strong>We retrospectively analyzed 100 consecutive patients with postoperative recurrence and compared their treatment response and survival outcomes in response to pembrolizumab plus CF therapy and conventional CF therapy.</p><p><strong>Results: </strong>Pembrolizumab plus CF therapy had higher response and objective response rates (41% vs. 27%, 77% vs. 57%, respectively) and prolonged progression-free survival (median 6.5 vs. 4.9 months, P = 0.011) and overall survival (not reached [NR] vs. 14.0 months, P = 0.087) compared to CF therapy. Early tumor shrinkage (ETS) ≧20% had a longer duration of response with pembrolizumab plus CF therapy compared with conventional CF therapy (NR vs. 10.2 months, P = 0.007). Conversely, the additional benefit of pembrolizumab in CF therapy was limited when ETS was <20% (4.0 vs. 3.4 months, P = 0.814). CF therapy was associated with worse survival outcomes for recurrences within 6 months post-surgery compared to those after 6 months. Pembrolizumab plus CF therapy provided comparable survival outcomes regardless of the timing of recurrence; however, it was less effective in combined positive score < 10 within the first 6 months.</p><p><strong>Conclusion: </strong>First-line pembrolizumab plus chemotherapy for postoperative recurrent esophageal cancer improved clinical outcomes compared to conventional CF therapy and can be expected to be one of the treatment options even in early postoperative recurrence.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of self-expanding metal stents in advanced esophageal cancer: a 12-year analysis in a referral center.","authors":"Bruno Costa Martins, Julia Mayumi Gregorio, Rafael Utimura Sueta, Déborah Marques Centeno, Pastor Joaquín Ortiz Mendieta, Marcelo Simas de Lima, Renata Nobre Moura, Luciano Lenz, Caterina Maria Pia Simioni Pennacchi, Andressa Abnader Machado, Rubens Antonio Aissar Sallum, Fauze Maluf-Filho","doi":"10.1093/dote/doaf039","DOIUrl":"10.1093/dote/doaf039","url":null,"abstract":"<p><p>Esophageal cancer is often diagnosed in advanced stages, leading to significant dysphagia and affecting patients' quality of life. This study aims to evaluate the efficacy and safety of self-expanding metallic stents (SEMS) for the palliative treatment of advanced esophageal cancer. This observational study was conducted in a tertiary cancer center, analyzing a prospectively maintained database where those undergoing SEMS placement between January 2009 and January 2021 were analyzed. Technical and clinical success rates, improvement in dysphagia and adverse events were analyzed. A total of 364 patients were included (291 men, mean age 60.8 years). The technical success was 100%, with 88% of patients showing improvement in dysphagia after stent placement. Adverse events occurred in 58% of cases, with stent-induced fistula (14%) and stent migration (9%) being the most common. There was no relationship between stent covering (partially versus fully covered) and adverse events (fistula P = 0.056; migration P = 0.264; in/overgrowth P = 0.825). Median overall survival was 207.2 days, with 1-month and 3-month survival rates of 82% and 66%, respectively. Placement of esophageal SEMS in patients with advanced esophageal tumors has high technical and clinical success rates. It immediately improves dysphagia in most patients. Stent-induced fistula and stent migration are the most common adverse events. Their occurrence is not influenced by previous chemo radiation or the type of stent covering. In most cases, they can be endoscopically managed.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic response to topical steroids is associated with a need for fewer future esophageal dilations.","authors":"Timothy S Gee, Sean S LaFata, Hannah L Thel, Brenderia A Cameron, Angela Z Xue, Akshatha Kiran, Adolfo A Ocampo, Justin McCallen, Christopher J Lee, Stephanie A Borinsky, Walker D Redd, Trevor S Barlowe, Rayan N Kaakati, Cary C Cotton, Swathi Eluri, Craig C Reed, Evan S Dellon","doi":"10.1093/dote/doaf032","DOIUrl":"10.1093/dote/doaf032","url":null,"abstract":"<p><p>The eosinophilic esophagitis (EoE) Endoscopic Reference Score (EREFS) measures endoscopic severity. While a score of ≤2 has been proposed for endoscopic response, it is unknown whether achieving this threshold results in clinically important outcomes. We aimed to determine whether an EREFS response to topical steroids (tCS) is associated with a decreased need for future esophageal dilation. In this retrospective cohort study, we included patients with a new diagnosis of EoE who underwent esophageal dilation, were then treated with tCS, and had at least two follow-up endoscopies. Endoscopic response was defined as EREFS ≤2. Histological and global symptom responses were recorded. We compared patients with and without endoscopic response and calculated the number of subsequent dilations in each group. Of 113 EoE patients, 55 (49%) had endoscopic response post-tCS. Compared to endoscopic non-responders, responders were older (43.4 vs 34.4 years; p = 0.001) and had lower EREFS (4.4 ± 1.6 vs. 6.3 ± 1.5; p < 0.001) at baseline. EREFS responders required fewer dilations on their initial post-treatment endoscopy (65% vs 90%; p = 0.002) and had greater symptom (92% vs 64%; p = 0.005) and histologic responses (82% vs 24% <15 eos/hpf; p < 0.001). Over the median follow-up time of 1106 days, EREFS responders required fewer dilations than non-responders (4.5 ± 2.9 vs 6.2 ± 4.5; p = 0.03). Endoscopic responders to tCS required fewer esophageal dilations compared to non-responders. Responders also had better symptom and histologic responses. These results provide evidence that endoscopic response is associated with important clinical outcomes including a reduction in future esophageal dilations.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lack of bidirectional associations between gastroesophageal reflux disease and periodontitis: a systematic review and meta-analysis.","authors":"Fang-Ping Shi, Zhao-Jie Zheng, Yu-Lu Chen","doi":"10.1093/dote/doaf031","DOIUrl":"https://doi.org/10.1093/dote/doaf031","url":null,"abstract":"<p><p>The bidirectional relationship between gastroesophageal reflux disease (GERD) and periodontitis (PD), particularly the temporal directionality, remains unclear. A systematic review and meta-analysis were conducted to evaluate bidirectional associations between GERD and PD. Three databases (PubMed, Embase, and Cochrane Library) were systematically searched from inception to December 1, 2024. Risk estimates from individual studies were pooled using random-effects models. Five studies assessed the risk of PD in patients with GERD, while three studies evaluated the risk of GERD in patients with PD. The overall analysis suggested an increased risk of PD among patients with GERD (odds ratio [OR] = 1.27; 95% confidence interval [CI]: 1.02-1.57; p = 0.029; I2 = 96.5%). However, sensitivity analyses, limited to cohort studies (OR = 1.15; 95% CI: 0.93-1.42; P = 0.05; I2 = 96.9%) and subgroup analyses, did not support this finding. Similarly, PD patients did not exhibit a higher risk of GERD (OR = 1.19; 95% CI: 0.90-1.57; P = 0.223; I2 = 94.3%). The present study could not confirm any bidirectional associations between GERD and PD. Further high-quality longitudinal studies are required to validate these findings.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}