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Surgical Treatment in Palliative Care

Multidisciplinary Treatment of Colorectal Cancer

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Multidisciplinary Treatment of Colorectal Cancer

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Abstract

Palliative surgery aims to relieve symptoms in patients with incurable disease by interventions. Traditionally, palliative surgery has been understood as non-curative surgery, i.e. non-resectional or R2 procedures, without sufficient attention to the impact on patients’ quality of life (QoL).

Palliative surgical procedures are indicated to relieve – or prevent – symptoms in patients with incurable disease in order to keep or improve the QoL. These interventions should fit into the patient’s general situation within the disease trajectory. Effective and empathic communication is essential to achieve a common understanding of the clinical situation, the individual treatment goals and expectations with regard to the effects of an intervention. Severe complications or any futile procedure, which may jeopardise the patient’s QoL, should be prevented. Palliative surgical procedures comprise any interventions, including conventional open surgery, minimally invasive procedures and endoscopic and percutaneous techniques. Indications and benefits have to be evaluated by patient-reported outcomes, e.g. by validated symptom scores.

Frequent palliative surgical scenarios include patients with surgically resectable but asymptomatic primary tumours with incurable metastatic disease or malignant bowel obstruction. Most patients will benefit from a multidisciplinary approach, which takes into account not only the physical but also the psychosocial and spiritual needs. The surgeon, as a part of the multidisciplinary palliative team, should add to the mutual efforts to improve the care for patients along a challenging last part of life.

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Author information

Authors and Affiliations

  1. Division of Colorectal Surgery, Department of Gastrointestinal Surgery, Stavanger University Hospital, 8100, N-4068, Stavanger, Norway

    Hartwig Kørner MD, PhD

  2. Department of Clinical Medicine, University of Bergen, Bergen, Norway

    Hartwig Kørner MD, PhD & Jon Arne Søreide MD, PhD, FACS

  3. Regional Centre of Excellence for Palliative Care Western Norway, Haukeland University Hospital, N-5021, Bergen, Norway

    Hartwig Kørner MD, PhD

  4. Division of HPB Surgery, Department of Gastrointestinal Surgery, Stavanger University Hospital, N-4068, Stavanger, Norway

    Jon Arne Søreide MD, PhD, FACS

Authors
  1. Hartwig Kørner MD, PhD
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  2. Jon Arne Søreide MD, PhD, FACS
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Correspondence to Hartwig Kørner MD, PhD .

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Editors and Affiliations

  1. Institute of Regional Health Science, University of Southern Denmark, Odense, Denmark

    Gunnar Baatrup

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Kørner, H., Søreide, J.A. (2015). Surgical Treatment in Palliative Care. In: Baatrup, G. (eds) Multidisciplinary Treatment of Colorectal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-06142-9_25

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  • DOI: https://doi.org/10.1007/978-3-319-06142-9_25

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-06142-9

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