Symptoms after upper gastrointestinal cancer surgery, such as dumping, reflux, diarrhoea, early satiety and weight loss, are common, overlap, and are managed inconsistently. The EUROSTAR consensus, published on 25 September 2026, brought together a multidisciplinary panel from ten European countries using the Perioperative Quality Initiative's modified Delphi process with GRADE-informed grading.
The panel agreed eight statements and 13 recommendations on symptom monitoring and service provision, together with diagnostic criteria, investigation pathways and management approaches for the common post-operative conditions, and identified 16 research priorities.
It is consensus, not trial evidence. Its value is in treating survivorship after gastrectomy and oesophagectomy as a structured part of care rather than something left to the surgical follow-up clinic.
- Ask about dumping, reflux, diarrhoea, early satiety and weight loss at every follow-up after gastrectomy or oesophagectomy.
- Use a structured symptom questionnaire so problems are not missed in short visits.
- Involve a dietitian early; nutrition problems drive many of the symptoms.
- Consider pancreatic enzyme insufficiency and bile acid diarrhoea when diarrhoea persists after surgery.
Why it matters
Survival after these operations is improving, and the quality of that survival depends on problems that are often not asked about.
Don't overread it
These are consensus recommendations, not new trial evidence, and the practice points here are ours rather than quoted from the consensus.
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