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

Autor:	Byrne BE; Department of Oeosphago-Gastric Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.; Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK., Siaw-Acheampong K; Department of Upper GI Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Evans O; Department of Upper Gastrointestinal Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK., Taylor J; Department of Upper Gastrointestinal Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK., Huddy F; Department of Nutrition and Dietetics, Royal Surrey NHS Foundation Trust, Guildford, UK., Nilsson M; Division of Surgery and Oncology, Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.; Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden.; Nuffield Department of Surgery, University of Oxford, Oxford, UK., Griffiths EA; Department of Upper GI Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.; Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK., Low D; Department of Thoracic Surgery, Virginia Mason Medical Centre, Seattle, Washington, USA., Gossage J; Department of Upper Gastrointestinal Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK., Dunn J; Department of Upper Gastrointestinal Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK., Zeki S; Department of Upper Gastrointestinal Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK., Markar S; Nuffield Department of Surgery, University of Oxford, Oxford, UK., Avery K; Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK., Blazeby JM; Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK., Cockbain A; Department of Upper GI Surgery, St James's University Hospital, Leeds, UK., Moss C; Faculty of Life Sciences and Medicine, King's College London, London, UK., van Hemelrijck M; Faculty of Life Sciences and Medicine, King's College London, London, UK., Andreyev J; Department of Gastroenterology, United Lincolnshire Hospitals NHS Trust, Lincoln, UK., Davies AR
Jazyk:	angličtina
Zdroj:	The British journal of surgery [Br J Surg] 2024 Nov 27; Vol. 111 (12).
DOI:	10.1093/bjs/znae286
Abstrakt:	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. (© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu