{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:11:18Z","timestamp":1791432678343,"version":"4.3.3"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T00:00:00Z","timestamp":1571011200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>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\u00a0days of surgery and late if present later than 14\u00a0days after surgery. The final criteria for early DGCE, accepted by 25 of 27 (93%) experts, were as follows: &amp;gt;500\u00a0mL diurnal nasogastric tube output measured on the morning of postoperative day 5 or later or\u2009&amp;gt;100% increased gastric tube width on frontal chest x-ray projection together with the presence of an air\u2013fluid level. The final criteria for late DGCE accepted by 89% of the experts were as follows: the patient should have \u2018quite a bit\u2019 or \u2018very much\u2019 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: \u2018not at all\u2019, \u2018a little\u2019, \u2018quite a bit\u2019, or \u2018very much\u2019, 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.<\/jats:p>","DOI":"10.1093\/dote\/doz074","type":"journal-article","created":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T08:48:58Z","timestamp":1571042938000},"source":"Crossref","is-referenced-by-count":59,"title":["Diagnostic criteria and symptom grading for delayed gastric conduit emptying after esophagectomy for cancer: international expert consensus based on a modified Delphi process"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7215-236X","authenticated-orcid":false,"given":"M","family":"Konradsson","sequence":"first","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden"},{"name":"Department of Gastroenterology, Landspitali National University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M I","family":"van Berge Henegouwen","sequence":"first","affiliation":[{"name":"Amsterdam UMC, location AMC, University of Amsterdam, Department of Surgery, Cancer Center Amsterdam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Bruns","sequence":"first","affiliation":[{"name":"Department of General, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M A","family":"Chaudry","sequence":"first","affiliation":[{"name":"Department of Surgery, Royal Marsden Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Cheong","sequence":"first","affiliation":[{"name":"Norfolk and Norwich University Hospital, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M A","family":"Cuesta","sequence":"first","affiliation":[{"name":"Department of Surgery, Amsterdam UMC, location VUmc, Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G E","family":"Darling","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Thoracic Surgery, University Health Network, University of Toronto, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9655-7601","authenticated-orcid":false,"given":"S S","family":"Gisbertz","sequence":"first","affiliation":[{"name":"Amsterdam UMC, location AMC, University of Amsterdam, Department of Surgery, Cancer Center Amsterdam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S M","family":"Griffin","sequence":"first","affiliation":[{"name":"Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C A","family":"Gutschow","sequence":"first","affiliation":[{"name":"Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"van Hillegersberg","sequence":"first","affiliation":[{"name":"Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Hofstetter","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A H","family":"H\u00f6lscher","sequence":"first","affiliation":[{"name":"Centre for Esophageal and Gastric Surgery, AGAPLESION Markus Krankenhaus, Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Kitagawa","sequence":"first","affiliation":[{"name":"Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J J B","family":"van Lanschot","sequence":"first","affiliation":[{"name":"Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Lindblad","sequence":"first","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden"},{"name":"Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L E","family":"Ferri","sequence":"first","affiliation":[{"name":"Department of Thoracic and Upper Gastrointestinal Surgery, McGill University Health Centre, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D E","family":"Low","sequence":"first","affiliation":[{"name":"Virginia Mason Medical Center, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M D P","family":"Luyer","sequence":"first","affiliation":[{"name":"Department of Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Ndegwa","sequence":"first","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Mercer","sequence":"first","affiliation":[{"name":"Queen Alexandra Hospital Portsmouth, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Moorthy","sequence":"first","affiliation":[{"name":"The Center for Visceral, Thoracic and Specialized Tumor Surgery, Hirslanden Medical Center, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C R","family":"Morse","sequence":"first","affiliation":[{"name":"Division of Thoracic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Nafteux","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium"},{"name":"Department of Chronic Diseases, Metabolism and Aging, KU Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G A P","family":"Nieuwehuijzen","sequence":"first","affiliation":[{"name":"Department of Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Pattyn","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Rosman","sequence":"first","affiliation":[{"name":"Department of surgery, Radboud university center Nijmegen, The 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