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 triggers to consider investigation for recurrence after oesophago-gastric cancer surgery was achieved. This may allow standardization and timely diagnosis and treatment of postoperative conditions, reducing variation in care and optimizing patients' quality of life.

中文翻译：

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食管胃癌切除德尔菲 （RESTOREd） 后症状的解决 - 标准化手术后胃肠道症状和病症的定义、调查和管理。


背景 食管胃癌手术对生活质量产生负面影响，术后症状负担高。手术后可能诊断和治疗的几种情况已被识别出来。然而，关于它们的定义和管理缺乏共识。本研究旨在就常见症状和病症的定义、调查和管理以及考虑疾病复发的触发因素达成共识，作为改善这些患者管理和生活质量的基础。方法 多学科专家小组的改良两轮 Delphi 共识研究。结果第 1 轮和第 2 轮收到了 127 份回复中的 86 份 （67.7%） 和 93 份回复中的 77 份 （82.8%）。在定义 26 种症状方面达成共识。对于 10 种情况 （吻合口狭窄、胃酸反流、非酸反流、胆道胃炎、胃排空延迟、倾倒综合征、胰腺外分泌功能不全、胆汁酸腹泻、小肠细菌过度生长和碳水化合物吸收不良），商定定义、诊断标准、一线和二线检查以及一线治疗。对于某些病症的三线检查，或对其他病症的二线、三线或四线治疗，未达成共识。14 种症状中有 12 种 （85.7%） 被公认为在术后早期 （<1 年） 和晚期 （>1 年） 考虑癌症复发的触发因素。结论 关于症状、病症和触发因素的专家共识，考虑检查食管胃癌手术后复发的情况。这可能允许对术后状况进行标准化和及时的诊断和治疗，减少护理的差异并优化患者的生活质量。