Introduction: Individuals with esophageal and gastroesophageal junction (GEJ) cancers are at especially high risk of malnutrition. However, most patients with malnutrition do not receive adequate nutritional support. We conducted a single-arm trial to test the implementation of Support Through Remote Observation and Nutrition Guidance (STRONG), a multilevel digital intervention to improve nutritional outcomes for patients with locally advanced esophageal and gastroesophageal junction cancer.
Methods: Participants received five nutritional counseling sessions with a dietitian, logged daily food intake through the Fitbit app, and completed five study assessments related to patient malnutrition, nutrition-related symptoms, and quality-of-life outcomes. We assessed the feasibility, acceptability, and usability of STRONG against a priori benchmarks.
Results: Participants (N = 17) had a median age of 68 years, and 71 % were male. Feasibility benchmarks were met for participants completing the baseline assessment (94 %), completing four out of five assessments (82 %), and participant retention (85 %). Among participants who only received an oral diet during the study period, adherence to dietetic appointments (89 %) and food intake tracking (78 %) were high. Participant recruitment rate (47 %) was slightly below the benchmark (50 %). All participants found the intervention to be acceptable. Usability of the intervention was high, with 69 % and 92 % of participants reporting high satisfaction with tracking food intake through the Fitbit and the dietitian-led nutrition counseling sessions, respectively.
Conclusion: Our study demonstrated that STRONG could be implemented with high feasibility, acceptability, and usability for esophageal and GEJ cancer patients. Findings from this study can guide a future efficacy study to assess the impact of STRONG on patient outcomes.
Clinical Trial Registration: The Support Through Remote Observation and Nutrition Guidance Program for Gastroesophageal Cancer Patients (STRONG-GEC) study was registered on clinicaltrials.gov (NCT05438940) in June 2022 prior to participant enrollment.
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http://dx.doi.org/10.1016/j.conctc.2024.101421 | DOI Listing |
World J Gastrointest Surg
January 2025
Department of Gastrointestinal Surgery, The Second People's Hospital of Lianyungang, Lianyungang 222000, Jiangsu Province, China.
Background: According to statistics, the incidence of proximal gastric cancer has gradually increased in recent years, posing a serious threat to human health. Tubular gastroesophageal anastomosis and double-channel anastomosis are two relatively mature anti-reflux procedures. A comparison of these two surgical procedures, tubular gastroesophageal anastomosis and double-channel anastomosis, has rarely been reported.
View Article and Find Full Text PDFInt J Surg
January 2025
Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
Background: The results of many large randomized clinical trials (RCTs) have transformed clinical practice in gastroesophageal reflux disease (GERD) and esophageal hiatal hernia (HH). However, research waste (i.e.
View Article and Find Full Text PDFJ Community Hosp Intern Med Perspect
January 2025
Holy Family Hospital, Rawalpindi, Pakistan.
Objectives: To determine the effect of actively training the crura of diaphragm which is a part of lower esophageal sphincter using abdominal breathing exercises to treat gastroesophageal reflux disease.
Methodology: With a randomized controlled study design, a total of 22 (11 in each group) clinically diagnosed patients of GERD presenting to the gastroenterology outpatient department at Holy Family Hospital in Pakistan were assessed using GERD related "quality of life index (QoLI)" questionnaire and their on-demand proton pump inhibitors (PPI) usage. Single blinding technique will be used.
Cureus
December 2024
Internal Medicine, Salmaniya Medical Complex, Manama, BHR.
Hiatal hernias occur when abdominal contents protrude into the posterior mediastinum through the esophageal hiatus of the diaphragm. They are classified into four types, with Type I (sliding) being the most prevalent. We report a case of a patient diagnosed with a large Type IV paraesophageal hernia.
View Article and Find Full Text PDFDig Liver Dis
January 2025
Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan; Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan. Electronic address:
Background: Patients with typical reflux symptoms and normal acid exposure time (AET) are classified as either reflux hypersensitivity (RH) or functional heartburn (FH), some of whom respond to proton pump inhibitors (PPIs). We determined if esophageal psychophysiological parameters predict PPI response in symptomatic RH and FH patients.
Methods: We prospectively recruited adults with heartburn diagnosed with RH or FH on 24-h impedance-pH monitoring off PPI.
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