Surgical palliation: getting back to our roots.
This article provides an overview of the approach to patients who may benefit from palliative care. While the article's details lend themselves to the treatment of complications secondary to advanced malignancies, the data herein can also be extrapolated to other chronic, terminal diseases. Guidelines for patient selection are discussed, using currently available outcomes data as a platform for the critical decision making process. Suggestions for a multidisciplinary team approach are offered, using the palliative triangle as the ideal model of communication and cooperation. Finally, methods for measuring success are detailed, along with proposals for how to better equip the surgeons of tomorrow with the knowledge and experience needed to tackle these difficult and intimate problems.
Thomay
Alan A
AA
Department of Surgery, The Alpert Medical School of Brown University, Rhode Island Hospital, 593 Eddy Street-APC 4, Providence, RI 02903, USA.
Jaques
David P
DP
Miner
Thomas J
TJ
D002908:Chronic Disease; D003142:Communication; D003657:Decision Making; D013502:General Surgery / Q000193:education; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000601:surgery*; D010166:Palliative Care; D010348:Patient Care Team; D010817:Physician-Patient Relations