Konradsson, M., Henegouwen, M. I. van Berge, Bruns, C., Chaudry, M. A., Cheong, E., Cuesta, M. A., Darling, G. E., Gisbertz, S. S., Griffin, S. M., Gutschow, C. A., van Hillegersberg, R., Hofstetter, W., Hoelscher, A. H., Kitagawa, Y., van Lanschot, J. J. B., Lindblad, M., Ferri, L. E., Low, D. E., Luyer, M. D. P., Ndegwa, N., Mercer, S., Moorthy, K., Morse, C. R., Nafteux, P., Nieuwehuijzen, G. A. P., Pattyn, P., Rosman, C., Ruurda, J. P., Rasanen, J., Schneider, P. M., Schroeder, W., Sgromo, B., Van Veer, H., Wijnhoven, B. P. L. and Nilsson, M. (2020). Diagnostic criteria and symptom grading for delayed gastric conduit emptying after esophagectomy for cancer: international expert consensus based on a modified Delphi process. Dis. Esophagus, 33 (4). CARY: OXFORD UNIV PRESS INC. ISSN 1442-2050

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Abstract

Delayed gastric conduit emptying (DGCE) after esophagectomy for cancer is associated with adverse outcomes and troubling symptoms. Widely accepted diagnostic criteria and a symptom grading tool for DGCE are missing. This hampers the interpretation and comparison of studies. A modified Delphi process, using repeated web-based questionnaires, combined with live interim group discussions was conducted by 33 experts within the field, from Europe, North America, and Asia. DGCE was divided into early DGCE if present within 14 days of surgery and late if present later than 14 days after surgery. The final criteria for early DGCE, accepted by 25 of 27 (93%) experts, were as follows: >500 mL diurnal nasogastric tube output measured on the morning of postoperative day 5 or later or>100% increased gastric tube width on frontal chest x-ray projection together with the presence of an air-fluid level. The final criteria for late DGCE accepted by 89% of the experts were as follows: the patient should have 'quite a bit' or 'very much' of at least two of the following symptoms; early satiety/fullness, vomiting, nausea, regurgitation or inability to meet caloric need by oral intake and delayed contrast passage on upper gastrointestinal water-soluble contrast radiogram or on timed barium swallow. A symptom grading tool for late DGCE was constructed grading each symptom as: 'not at all', 'a little', 'quite a bit', or 'very much', generating 0, 1, 2, or 3 points, respectively. For the five symptoms retained in the diagnostic criteria for late DGCE, the minimum score would be 0, and the maximum score would be 15. The final symptom grading tool for late DGCE was accepted by 27 of 31 (87%) experts. For the first time, diagnostic criteria for early and late DGCE and a symptom grading tool for late DGCE are available, based on an international expert consensus process.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Konradsson, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Henegouwen, M. I. van BergeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bruns, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chaudry, M. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cheong, E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cuesta, M. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Darling, G. E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gisbertz, S. S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Griffin, S. M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gutschow, C. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Hillegersberg, R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hofstetter, W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoelscher, A. H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kitagawa, Y.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Lanschot, J. J. B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lindblad, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ferri, L. E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Low, D. E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Luyer, M. D. P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ndegwa, N.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mercer, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moorthy, K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Morse, C. R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nafteux, P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nieuwehuijzen, G. A. P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pattyn, P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rosman, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruurda, J. P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rasanen, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schneider, P. M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schroeder, W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sgromo, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Van Veer, H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wijnhoven, B. P. L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nilsson, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-337784
DOI: 10.1093/dote/doz074
Journal or Publication Title: Dis. Esophagus
Volume: 33
Number: 4
Date: 2020
Publisher: OXFORD UNIV PRESS INC
Place of Publication: CARY
ISSN: 1442-2050
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
QUALITY-OF-LIFE; PYLORIC DRAINAGE; RISK-FACTORS; MANAGEMENTMultiple languages
Gastroenterology & HepatologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/33778

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