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La nouvelle classification de Savary des œsophagites de reflux

Savary’s new endoscopic classification of reflux oesophagitis

Nueva clasificación endoscópica de Savary de las esofagitis por reflujo

Die neue Klassifikation der Refluxösophagitis nach Savary

La nuova classificazione di Savary dell’esofagite da reflusso

  • Published:
Acta Endoscopica

Résumé

Comme la classification de Savary-Miller dont elle adopte l’essentiel, la classification de l’œsophagite par refluxen 5 types de Savary-Monnier repose sur une analyse rigoureuse et précise des lésions endoscopiques. Ses principales qualités sont d’être simple, complète, logique et souple. Son impact sur la pratique est certain puisqu’elle a une excellente valeur pronostique et qu’elle permet de choisir la bonne stratégie thérapeutique. De plus, en isolant les cicatrices cylindriques (seules précancéroses à surveiller à long terme) elle permet de les utiliser pour préciser la topographie des œsophagites de reflux.

Summary

The Savary- Monnier classification of reflux oesophagitis into 5 types relies on the rigorous and accurate analysis of endoscopic lesions. It is based for the essentials on the earlier Savary- Miller grading (1974). It has the advantage to be simple, exhaustive, logic and adaptable. Its impact on clinical practice is undeniable since it has an excellent prognostic value and indicates the best choice of therapeutic strategy. Moreover, by setting apart the cylindric cell scars (the only precancerous lesions needing a long term surveillance), this grading allows to specify the topography of reflux oesophagitis.

Resumen

Como la clasificación de Savary- Miller de la cual adopta lo esencial, la clasificaeión de la esofagitis por reflujo en 5 tiposde Savary- Monnier reposa sobre un análisis riguroso y preciso de las lesiones endoscópicas. Sus principales cualidades son la de ser simple, completa, lógica y flexible. Su impacto en la práctica es efectiva ya que tiene un excelente valor pronóstico y permite escoger la correcta estrategia terapéutica. Además, excluyendo las cicatrices cilindricas (solo las precancerosas de vigilancia a largo plazo), ella permite utilizarla para precisar la topografia de las esofagitis por reflujo.

Zusammenfassung

Wie die Klassifikation nach Savary- Miller, wovon sie die wesentlichen Punkte übernimmt, basiert die Einteilung der Refluxösophagitis in 5 Stadien nach Savary- Monnier auf einer strengen und genauen endoskopischen Untersuchung der Läsionen. Ihre grundlegenden Eigenschaften sind die Einfachheit, Vollständigkeit, der logische Aufbau und die Anpassungsfähigkeit. Ihre Bedeutung für die Praxis ist gegeben, da sie eine hervorragenden prognostischen Wert besitzt und so die Auswahl der geeigneten therapeutische Strategie erlaubt.

Darüberhinaus erlaubt sie Präzisierung der Topographie der Refluxösphagitis im Fall von Narben im Bereich des Zylinderepithels (der einzigen Präkanzerose, die über lange Zeit beobachtet werden muβ .

Riassunto

La nuova classificazione della esofagite da reflusso in 5 stadidi Savary- Monnier deriva come quella di Savary- Miller da una analisi rigorosa e precisa delle lesioni endoscopiche. Le sue caratteristiche peculiari sono la semplicità, la completezza, la logica e la sua adattabilitànella tipizzazione delle varie lesioni. Il suo valore prognostico permette, da un punto di vista pratico, di scegliere la strategia terapeutica piùadatta al tipo di lesione. In più, isolando le cicatrici di forma cilindrica (le sole da sorvegliare a lungo termine per la loro potenzialitàprecancerosa) essa permette di utilizzarle nel precisare correttamente la topografia delle lesioni dell’esofagite da reflusso.

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    J. -B. Ollyo, Ch. Fontolliet, E. Brossard & F. Lang

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Ollyo, J.B., Fontolliet, C., Brossard, E. et al. La nouvelle classification de Savary des œsophagites de reflux. Acta Endosc 22, 307–320 (1992). https://doi.org/10.1007/BF02965163

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