Evidence map›Paper›PMID 31608938›Full record

ArticleDiseases of the esophagus : official journal of the International Society for Diseases of the Esophagus2020

Diagnostic criteria and symptom grading for delayed gastric conduit emptying after esophagectomy for cancer: international expert consensus based on a modified Delphi process.

M Konradsson, M I van Berge Henegouwen, C Bruns, M A Chaudry, E Cheong, M A Cuesta, G E Darling, S S Gisbertz, S M Griffin, C A Gutschow and 25 more

2 registry-linked trialsAbstract readConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Article in Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 33 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05802459 recruitingnot on this mapstarted 2022, after this paper: background citation

Prospective Evaluation of the Functional Status of Jejunoplasty and Coloplasty in Patients Undergoing Complex Esophageal Reconstruction and Its Impact on Quality of Life (CEREC)

Typeobservational_patient_registrySponsorHospital Universitari de BellvitgeRan2022 to 2027Enrolled36ConditionsQuality of Life, DysphagiaArmsEORTC QLQ-C30, EORTC QLQ-OG25, GIQLI, SWAL QoL, Videofluoroscopy
NCT07355374 narecruitingnot on this mapstarted 2025, after this paper: background citation

Patients With Esophageal Carcinoma Undergoing Minimally Invasive Ivor Lewis Esophagectomy With or Without Intraoperative Endoscopic Pylorus Balloon Dilation: A Randomized Controlled Trial Investigating the Benefits of Intraoperative Endoscopic Pylorus Dilation

TypeinterventionalSponsorUniversity Hospital, Basel, SwitzerlandRan2025 to 2028Enrolled116ConditionsDelayed Gastric Conduit Emtpying (DGCE), Minimally-invasive EsophagectomyArmsendoscopic plyoric balloon dilatation performed by experienced gastroenterologists
3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  9. Revisional surgery for delayed gastric conduit emptying after esophagectomy: the RESTORANT project.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2026
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  16. Delayed gastric conduit emptying after esophagectomy: attempt at a clinically relevant classification.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

35 authors.

M KonradssonDepartment of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
M I van Berge HenegouwenAmsterdam UMC, location AMC, University of Amsterdam, Department of Surgery, Cancer Center Amsterdam.
C BrunsDepartment of General, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany.
M A ChaudryDepartment of Surgery, Royal Marsden Hospital, London, UK.
E CheongNorfolk and Norwich University Hospital, Norwich, UK.
M A CuestaDepartment of Surgery, Amsterdam UMC, location VUmc, Amsterdam, Netherlands.
G E DarlingDepartment of Surgery, Division of Thoracic Surgery, University Health Network, University of Toronto, Toronto, Canada.
S S GisbertzAmsterdam UMC, location AMC, University of Amsterdam, Department of Surgery, Cancer Center Amsterdam.
S M GriffinNorthern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
C A GutschowDepartment of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.
R van HillegersbergUniversitair Medisch Centrum Utrecht, Utrecht, The Netherlands.
W HofstetterDepartment of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
A H HölscherCentre for Esophageal and Gastric Surgery, AGAPLESION Markus Krankenhaus, Frankfurt, Germany.
Y KitagawaDepartment of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
J J B van LanschotDepartment of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
M LindbladDepartment of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
L E FerriDepartment of Thoracic and Upper Gastrointestinal Surgery, McGill University Health Centre, Montreal, QC, Canada.
D E LowVirginia Mason Medical Center, Seattle, WA, USA.
M D P LuyerDepartment of Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands.
N NdegwaDepartment of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
S MercerQueen Alexandra Hospital Portsmouth, United Kingdom.
K MoorthyThe Center for Visceral, Thoracic and Specialized Tumor Surgery, Hirslanden Medical Center, Zurich, Switzerland.
C R MorseDivision of Thoracic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
P NafteuxDepartment of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium.
G A P NieuwehuijzenDepartment of Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands.
P PattynDepartment of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium.
C RosmanDepartment of surgery, Radboud university center Nijmegen, The Netherlands.
J P RuurdaUniversitair Medisch Centrum Utrecht, Utrecht, The Netherlands.
J RäsänenDepartment of General, Thoracic and Esophageal Surgery, Heart and Lung Center, Helsinki University Hospital and Helsinki University, Helsinki, Finland.
P M SchneiderThe Center for Visceral, Thoracic and Specialized Tumor Surgery, Hirslanden Medical Center, Zurich, Switzerland.
W SchröderDepartment of General, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany.
B SgromoOxford University Hospitals, Oxford, UK.
H Van VeerDepartment of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium.
B P L WijnhovenDepartment of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
M NilssonDepartment of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

AdultDelphi TechniqueEsophageal Motility DisordersEsophageal NeoplasmsEsophagectomyFemaleGastric EmptyingHumansMaleMiddle AgedPostoperative ComplicationsSymptom AssessmentTreatment Outcomeconsensusesophagectomygastric emptyingmalnutrition

Identifiers

PMID31608938
PMCPMC7150655

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.