{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T13:06:14Z","timestamp":1792587974048,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T00:00:00Z","timestamp":1736121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T00:00:00Z","timestamp":1736121600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>High\u2010resolution manometry (HRM) allows assessment of esophagogastric junction (EGJ) disruption. While type 3 EGJ predicts definitive gastroesophageal reflux disease (GERD), type 2 EGJ is less clearly implicated in GERD pathogenesis. This study aimed to characterize physiologic findings in type 2 EGJ to determine if the HRM\u2010based Milan Score can define GERD within type 2 EGJ.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>535 patients with suspected GERD who underwent HRM and reflux monitoring were retrospectively analyzed. Clinical, HRM, and reflux study data were compared between the EGJ morphology subtypes, with objective GERD defined according to Lyon Consensus 2.0. The Milan Score, a novel metric that integrates ineffective esophageal motility, EGJ\u2010contractile integral, EGJ morphology, and straight leg raise response, was abnormal when \u2265\u2009137 (risk rate 50% for GERD). Receiver operating characteristic (ROC) curve analysis was performed to assess the accuracy of the Milan Score to predict objective GERD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Type 3 EGJ was associated with the highest rate of objective GERD, followed by type 2 and type 1 EGJ (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with a corresponding stepwise increase in AET from type 1 to 3 EGJ (p\u2009&lt;\u20090.001). Type 2 EGJ with Milan Score\u2009&lt;\u2009137 resembled type 1 EGJ (objective GERD in 23.6% vs. 33.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.09), and type 2 EGJ with score\u2009\u2265\u2009137 resembled type 3 EGJ (objective GERD in 88.2% vs. 78.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.11). On ROC analysis, the Milan Score had an area under the curve of 0.858.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While type 2 EGJ includes varying GERD severity, the Milan Score can segregate patients at risk for objective GERD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.14987","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T04:50:03Z","timestamp":1736139003000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The Milan Score Predicts Objective Gastroesophageal Reflux Disease in Patients With Type 2 Esophagogastric Junction"],"prefix":"10.1111","volume":"38","author":[{"given":"Davide","family":"Ferrari","sequence":"first","affiliation":[{"name":"Division of General and Emergency Surgery, IRCCS Policlinico San Donato University of Milan  San Donato Milanese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0532-3135","authenticated-orcid":false,"given":"Stefano","family":"Siboni","sequence":"additional","affiliation":[{"name":"Division of General and Emergency Surgery, IRCCS Policlinico San Donato University of Milan  San Donato Milanese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1153-123X","authenticated-orcid":false,"given":"Marco","family":"Sozzi","sequence":"additional","affiliation":[{"name":"Division of General and Emergency Surgery, IRCCS Policlinico San Donato University of Milan  San Donato Milanese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6985-5301","authenticated-orcid":false,"given":"Pierfrancesco","family":"Visaggi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7999-1625","authenticated-orcid":false,"given":"Ivan","family":"Kristo","sequence":"additional","affiliation":[{"name":"Upper\u2010GI\u2010Service, Medizinische Universit\u00e4t  Wien Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1653-9903","authenticated-orcid":false,"given":"Salvatore","family":"Tolone","sequence":"additional","affiliation":[{"name":"Division of General, Mini\u2010Invasive and Bariatric Surgery Universita degli Studi della Campania, School of Medicine  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Marabotto","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit IRCCS Policlinico San Martino  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Bernardi","sequence":"additional","affiliation":[{"name":"Division of General and Emergency Surgery, IRCCS Policlinico San Donato University of Milan  San Donato Milanese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian F.","family":"Schoppmann","sequence":"additional","affiliation":[{"name":"Upper\u2010GI\u2010Service, Medizinische Universit\u00e4t  Wien Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin D.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Hobson","sequence":"additional","affiliation":[{"name":"The Functional Gut Clinic  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5325-0789","authenticated-orcid":false,"given":"Jordan","family":"Haworth","sequence":"additional","affiliation":[{"name":"The Functional Gut Clinic  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6486-7717","authenticated-orcid":false,"given":"Yeong Yeh","family":"Lee","sequence":"additional","affiliation":[{"name":"School of Medical Sciences and GI Function and Motility Unit Universiti Sains Malaysia  Kota Bharu Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian E.","family":"Louie","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Swedish Medical Center Digestive Health Institute  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Masuda","sequence":"additional","affiliation":[{"name":"Department of Surgery Jikei University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan L.","family":"Ivy","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Swedish Medical Center Digestive Health Institute  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Milito","sequence":"additional","affiliation":[{"name":"Division of General and Emergency Surgery, IRCCS Policlinico San Donato University of Milan  San Donato Milanese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Centorrino","sequence":"additional","affiliation":[{"name":"Division of General and Emergency Surgery, IRCCS Policlinico San Donato University of Milan  San Donato Milanese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Theodorou","sequence":"additional","affiliation":[{"name":"Foregut Surgery Unit University of Athens School of 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Motility Unit Universiti Sains Malaysia  Kota Bharu Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Cusmai","sequence":"additional","affiliation":[{"name":"Division of General and Emergency Surgery, IRCCS Policlinico San Donato University of Milan  San Donato Milanese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6918-9479","authenticated-orcid":false,"given":"Roberto","family":"Penagini","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Coletta","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan 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