Skip to main content

Surgical Emergencies in the Palliative Care Setting

  • Chapter
  • First Online:
Surgical Emergencies in the Cancer Patient

Abstract

Palliative care may be defined as “an interdisciplinary team approach to care with a focus on comfort and quality of life rather than prolongation or ‘cure’ for a patient and their loved ones” (Cancer Epidemiol Biomarkers Prev 13:337–339, 2004). This definition stresses the interdisciplinary nature of palliative care, and marks the importance of the surgeon in this setting. Emergency situations are crystallized in the setting of advanced disease. The decision making may be especially difficult not only for patients and caregivers, but also for clinical teams. Fortunately, true emergencies are rare and typically allow time to consider the risks and potential benefits of surgical interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Krouse RS, Rosenfeld KE, Grant M, Aziz N, Byock I, Sloan J, et al. Palliative care research: issues and opportunities. Cancer Epidemiol Biomarkers Prev. 2004;13:337–9.

    PubMed  Google Scholar 

  2. Krouse RS, Nelson R, Ferrell B, Grube B, Juarez G, Wagman LD, Chu DZJ. Surgical palliation at a cancer center: incidence and outcomes. Arch Surg. 2001;136:773–8.

    Article  CAS  PubMed  Google Scholar 

  3. Badgwell BD, Smith K, Liu P, Bruera E, Curley SA, Cormier JN. Indicators of surgery and survival in oncology inpatients requiring surgical evaluation for palliation. Support Care Cancer. 2009;17:727–34.

    Article  PubMed  Google Scholar 

  4. McCahill LE, Krouse R, Chu D, Juarez G, Uman GC, Ferrell B, Wagman LD. Indications and use of palliative surgery: results of Society of Surgical Oncology survey. Ann Surg Oncol. 2002;2:104–12.

    Article  Google Scholar 

  5. Smith TJ, Temin S, Alesi ER, Abernethy AP, Balboni TA, Basch EM, et al. American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. J Clin Oncol. 2012;30:880–7.

    Article  PubMed  Google Scholar 

  6. Yeung S-CJ, Escalante CP. Oncologic emergencies. London: BC Decker; 2002.

    Google Scholar 

  7. Badgwell B. Oncologic emergencies. In: Ching DC, editor. Feig BW. Lippincott Williams & Wilkins: The M.D. Anderson surgical oncology handbook. Philadelphia; 2011. p. 764–77.

    Google Scholar 

  8. Markman M. Surgery for support and palliation in patients with malignant disease. Semin Oncol. 1995;22:91–4.

    CAS  PubMed  Google Scholar 

  9. Miner TJ, Jaques DP, Tavaf-Motamen H, Shriver CD. Decision making on surgical palliation based on patient outcome data. Am J Surg. 1999;177:150–4.

    Article  CAS  PubMed  Google Scholar 

  10. Ware Jr JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–83.

    Article  PubMed  Google Scholar 

  11. Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, et al. The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol. 1993;11:570–9.

    CAS  PubMed  Google Scholar 

  12. Ferrell BR, Chu DZ, Wagman L, Juarez G, Borneman T, Cullinane C, et al. Online exclusive: patient and surgeon decision making regarding surgery for advanced cancer. Oncol Nurs Forum. 2003;30:E106–14.

    Article  PubMed  Google Scholar 

  13. Schmidt C, Gerdes H, Hawkins W, Zucker E, Zhou Q, Riedel E, et al. A prospective observational study examining quality of life in patients with malignant gastric outlet obstruction. Am J Surg. 2009;198:92–9.

    Article  PubMed  Google Scholar 

  14. Badgwell B, Krouse R, Cormier J, Guevara C, Klimberg VS, Ferrell B. Ann Surg Oncol. 2012;19:3651–8.

    Article  PubMed  Google Scholar 

  15. Leiter U, Buettner PG, Bohnenberger K, Eigentler T, Meier F, Moehrle M, et al. Sentinel lymph node dissection in primary melanoma reduces subsequent regional lymph node metastasis as well as distant metastasis after nodal involvement. Ann Surg Oncol. 2010;17:129–37.

    Article  PubMed  Google Scholar 

  16. Cady B, Easson A, Aboulafia AJ, Ferson PF. Part 1: Surgical palliation of advanced illness—what’s new, what’s helpful. J Am Coll Surg. 2005;200:115–27.

    Article  PubMed  Google Scholar 

  17. Ripamonti C, Twycross R, Baines M, Bozzetti F, Capri S, De Conno F, et al. Clinical-practice recommendations for the management of bowel obstruction in patients with end-stage cancer. Support Care Cancer. 2001;9:223–33.

    Article  CAS  PubMed  Google Scholar 

  18. Serpell JW, Carne PW, Bailey M. Radical lymph node dissection for melanoma. ANZ J Surg. 2003;73:294–9.

    Article  PubMed  Google Scholar 

  19. Persson E, Wilde Larsson B. Quality of care after ostomy surgery: a perspective study of patients. Ostomy Wound Manage. 2005;51:40–8.

    PubMed  Google Scholar 

  20. Badgwell BD, Contreras C, Askew R, Krouse R, Feig B, Cormier JN. Radiographic and clinical factors associated with improved outcomes in advanced cancer patients with bowel obstruction. J Palliat Med. 2011;14:990–6.

    Article  PubMed  Google Scholar 

  21. Krouse RS. The international conference on malignant bowel obstruction: a meeting of the minds to advance palliative care research. J Pain Symptom Manage. 2007;34(1 Suppl):S1–6.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Anthony T, Baron T, Mercadante S, Green S, Chi D, Cunningham J, et al. Report of the clinical protocol committee: development of randomized trials for malignant bowel obstruction. J Pain Symptom Manage. 2007;34(1 Suppl):S49–59.

    Article  PubMed  Google Scholar 

  23. Francescutti V, Miller A, Satchidanand Y, Alvarez-Perez A, Dunn KB. Management of bowel obstruction in patients with stage IV cancer: predictors of outcome after surgery. Ann Surg Oncol. 2013;20:707–14.

    Article  PubMed  Google Scholar 

  24. Badgwell BD, Aloia TA, Garrett J, Chedister G, Miner T, Krouse R. Indicators of symptom improvement and survival in inpatients with advanced cancer undergoing palliative surgical consultation. J Surg Oncol. 2013;107:367–71.

    Article  PubMed  Google Scholar 

  25. Badgwell B, Krouse R, Klimberg SV, Bruera E. Outcome measures other than morbidity and mortality for patients with incurable cancer and gastrointestinal obstruction. J Palliat Med. 2014;17:18–26.

    Article  PubMed  Google Scholar 

  26. Miner TJ, Brennan MF, Jaques DP. A prospective, symptom related, outcomes analysis of 1022 palliative procedures for advanced cancer. Ann Surg. 2004;240:719–26; discussion 717–26.

    PubMed  PubMed Central  Google Scholar 

  27. Abbas SM, Merrie AE. Resection of peritoneal metastases causing malignant small bowel obstruction. World J Surg Oncol. 2007;5:122.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Amikura K, Sakamoto H, Yatsuoka T, Kawashima Y, Nishimura Y, Tanaka Y. Surgical management for a malignant bowel obstruction with recurrent gastrointestinal carcinoma. J Surg Oncol. 2010;101:228–32.

    PubMed  Google Scholar 

  29. Dalal KM, Gollub MJ, Miner TJ, Wong WD, Gerdes H, Schattner MA, et al. Management of patients with malignant bowel obstruction and stage IV colorectal cancer. J Palliat Med. 2011;14:822–8.

    Article  PubMed  Google Scholar 

  30. Blair SL, Chu DZ, Schwarz RE. Outcome of palliative operations for malignant bowel obstruction in patients with peritoneal carcinomatosis from nongynecological cancer. Ann Surg Oncol. 2001;8:632–7.

    Article  CAS  PubMed  Google Scholar 

  31. Chakraborty A, Selby D, Gardiner K, Myers J, Moravan V, Wright F. Malignant bowel obstruction: natural history of a heterogeneous patient population followed prospectively over two years. J Pain Symptom Manage. 2011;41:412–20.

    Article  PubMed  Google Scholar 

  32. Chandrasegaram MD, Eslick GD, Mansfield CO, Liem H, Richardson M, Ahmed S, et al. Endoscopic stenting versus operative gastrojejunostomy for malignant gastric outlet obstruction. Surg Endosc. 2012;26:323–9.

    Article  PubMed  Google Scholar 

  33. Tang E, Davis J, Silberman H. Bowel obstruction in cancer patients. Arch Surg. 1995;130:832–6; discussion 836–7.

    Article  CAS  PubMed  Google Scholar 

  34. Ly J, O’Grady G, Mittal A, Plank L, Windsor JA. A systematic review of methods to palliate malignant gastric outlet obstruction. Surg Endosc. 2010;24:290–7.

    Article  PubMed  Google Scholar 

  35. Brimhall B, Adler DG. Enteral stents for malignant gastric outlet obstruction. Gastrointest Endosc Clin N Am. 2011;21:389–403, vii–viii.

    Google Scholar 

  36. Sagar J. Colorectal stents for the management of malignant colonic obstructions. Cochrane Database Syst Rev. 2011;11:CD007378.

    Google Scholar 

  37. Lau JY, Sung JJ, Lam YH, Chan AC, Ng EK, Lee DW, et al. Endoscopic retreatment compared with surgery in patients with recurrent bleeding after initial endoscopic control of bleeding ulcers. N Engl J Med. 1999;340:751–6.

    Article  CAS  PubMed  Google Scholar 

  38. Ferris FD, Bezjak A, Rosenthal SG. The palliative uses of radiation therapy in surgical oncology patients. Surg Oncol Clin N Am. 2001;10:185–201.

    CAS  PubMed  Google Scholar 

  39. Badgwell BD, Camp ER, Feig B, Wolff RA, Eng C, Ellis LM, et al. Management of bevacizumab-associated bowel perforation: a case series and review of the literature. Ann Oncol. 2008;19:577–82.

    Article  CAS  PubMed  Google Scholar 

  40. Badgwell B, Feig BW, Ross MI, Mansfield PF, Wen S, Chang GJ. Pneumoperitoneum in the cancer patient. Ann Surg Oncol. 2007;14:3141–7.

    Article  PubMed  Google Scholar 

  41. Facchiano E, Risio D, Kianmanesh R, Msika S. Laparoscopic hyperthermic intraperitoneal chemotherapy: indications, aims, and results: a systematic review of the literature. Ann Surg Oncol. 2012;19:2946–50.

    Article  PubMed  Google Scholar 

  42. Valle M, Van der Speeten K, Garofalo A. Laparoscopic hyperthermic intraperitoneal peroperative chemotherapy (HIPEC) in the management of refractory malignant ascites: a multi-institutional retrospective analysis in 52 patients. J Surg Oncol. 2009;100:331–4.

    Article  CAS  PubMed  Google Scholar 

  43. Paz IB. Major palliative amputations. Surg Oncol Clin N Am. 2004;13:543–7.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert S. Krouse M.D., F.A.C.S. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Krouse, R.S., Badgwell, B. (2017). Surgical Emergencies in the Palliative Care Setting. In: Fong, Y., Kauffmann, R., Marcinkowski, E., Singh, G., Schoellhammer, H. (eds) Surgical Emergencies in the Cancer Patient. Springer, Cham. https://doi.org/10.1007/978-3-319-44025-5_30

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-44025-5_30

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-44023-1

  • Online ISBN: 978-3-319-44025-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics