REsolution of Symptoms afTer Oesophago-gastric cancer REsection delphi (RESTOREd)—standardizing the definition, investigation and management of gastrointestinal symptoms and conditions after surgery

作者：Ben Byrne, K Siaw-Acheampong, Orla Evans, Joanna Taylor, Fiona Huddy, Magnus Nilsson, Ewen A. Griffiths, Donald E. Low, James Gossage, Jason Dunn, Sebastian Zeki, Sheraz R. Markar, Kerry Avery, Jane Blazeby, Andrew J. Cockbain, Charlotte Moss, Mieke Van Hemelrijck, Jervoise Andreyev, Andrew Davies, RESTORE Delphi study group, William Allum, A Chaudry, Sacheen Kumar, Ann Muls, Clare Shaw, Cara Baker, Annie E. Coombes, Mark Kelly, Terence Z. Wong, Ian Beales, Richard Berrisford, Alexander Wright, P Boger, David Bunting, N Carter, S Mercer, Philip H. Pucher, Barry Robinson, E Cheong, Bhaskar Kumar, M. Cominos, Mark Hill, John K. Waters, Graeme Couper, Richard J. E. Skipworth, Andrew Cowie, T. Crosby, David Dewar, Anjan Dhar, Michelle Fanning, C. Fleuret, M. J. Forshaw, Vicky Goh, Nyree Griffin, Tarun Sabharwal, Hasan Haboubi, Anthony Hobson, Arul Immanuel, Alex Phillips, Jafar Jafari, Jesper Lagergren, Timothy A. Lander, Steven D. Leach, L B Lovat, Ailsa Sita-Lumsden, N Maisey, Sam Ngan, A. Qureshi, Inder Mainie, Nick Maynard, W M Melia, B Warner, Borzoueh Mohammadi, Aideen M. Moore, Fergus Noble, S. Parsons, Russell Petty, Nicholas Power, D. Mark Pritchard, N Ravi, James D. Reynolds, William Robb, Sara Ryan, Tim J. Sloan, Elizabeth Smyth, Manil Subesinghe, Javed Sultan, Rami Sweis, Nigel Trudgill, Olga Tucker, Richard Turkington, T Underwood, Lesley Ward, Christopher J. White, J Whiting · 发表于：British journal of surgery · 年份：2024 · DOI：10.1093/bjs/znae286 · 被引用次数：5 · 研究领域：Esophageal Cancer Research and Treatment、Gastric Cancer Management and Outcomes、Enhanced Recovery After Surgery

BACKGROUND: Oesophago-gastric cancer surgery negatively affects quality of life with a high postoperative symptom burden. Several conditions that may be diagnosed and treated after surgery are recognised. However, consensus regarding their definition and management is lacking. This study aimed to develop consensus regarding the definition, investigation and management of the common symptoms and conditions, and triggers to consider disease recurrence, as a foundation for improving management and quality of life in these patients. METHOD: Modified two-round Delphi consensus study of a multidisciplinary expert panel. RESULTS: Eighty-six of 127 (67.7%) and 77 of 93 (82.8%) responses were received in rounds 1 and 2. Consensus was achieved in defining 26 symptoms. For 10 conditions (anastomotic stricture, acid reflux, non-acid reflux, biliary gastritis, delayed gastric emptying, dumping syndrome, exocrine pancreatic insufficiency, bile acid diarrhoea, small intestinal bacterial overgrowth and carbohydrate malabsorption), definitions, diagnostic criteria, first- and second-line investigation and first-line treatments were agreed. Consensus was not reached for third-line investigation of some conditions, or for second-, third- or fourth-line treatments for others. Twelve of 14 (85.7%) symptoms were agreed as triggers to consider cancer recurrence, during the early (<1 year) and late (>1 year) postoperative periods. CONCLUSION: Expert consensus regarding symptoms, conditions and trigg...