Makuuchi H, Shimada H, Chino O, Nishi T, Tanaka H, Ohshiba G
Department of Surgery, Tokai University, School of Medicine, Isehara, Japan.
Nihon Geka Gakkai Zasshi. 1997 Nov;98(11):926-31.
Endoscopic diagnosis and classification of reflux esophagitis were described, which is gradually increasing in number in Japan. It is important to diagnosefor a type, grade, and degree, hearing stage and others (stenosis, Barrett's esophagus etc), when we perform endoscopic examination for reflux esophagitis patients. Iodine staining should be applied as far as possible. Los Angeles system for classification of reflux esophagitis was proposed at the 10th World Congress of Gastroenterology in October 1994. As for LA classification, reflux esophagitis is classified to 4 grade, from A to D, predicated on the grade of mucosal break. For any doctors, this is easy to apply to the classification of reflux esophagitis and the diagnosis of classification will be equal. The Japanese Society of Disease of Esophagus also proposed the new classification of reflux esophagitis, that is JSED '96 Classification. This classification contains grade 0, which indicate no reflux esophagitis and grade 1, which indicate the discoloring type of esophagitis. Another 3 grades are based on the length of esophagitis and also occupation on circumference of esophagus. This will be suitable for the Japanese reflux esophagitis and can be changed to LA classification easily. The International Society of Disease of Esophagus proposed AFP classification which is useful to decide the application to surgical treatment. The detail of these classifications and the important points on the endoscopic diagnosis of reflux esophagitis were mentioned in this paper.
本文描述了反流性食管炎的内镜诊断及分类,在日本其发病率正逐渐上升。当我们对反流性食管炎患者进行内镜检查时,对其类型、分级、程度、分期及其他情况(狭窄、巴雷特食管等)进行诊断非常重要。应尽可能应用碘染色。1994年10月在第十届世界胃肠病学大会上提出了反流性食管炎的洛杉矶分类系统。对于洛杉矶分类,反流性食管炎根据黏膜破损程度分为A至D四级。对于任何医生来说,这都易于应用于反流性食管炎的分类,且诊断分类结果会一致。日本食管疾病学会也提出了反流性食管炎的新分类,即JSED '96分类。该分类包括表示无反流性食管炎的0级和表示食管炎变色类型的1级。另外3级基于食管炎的长度以及食管圆周的累及情况。这适用于日本的反流性食管炎,且可轻松转换为洛杉矶分类。国际食管疾病学会提出了AFP分类,这对于决定是否应用手术治疗很有用。本文提到了这些分类的详细内容以及反流性食管炎内镜诊断的要点。