Optimizing Palliative Surgical Support of Cancer Patients with Visceral Obstructions

Abstract

Visceral obstruction aggravates surgical problems in cancer patients. It can lead to major organ failure either directly (e.g. hepatic failure from biliary obstruction) or indirectly from complications (e.g. cholecystitis and septicaemia) which in turn can be rapidly fatal. Visceral obstruction often causes a rapid downturn in quality of life (e.g. with pain, distension and vomiting from bowel obstruction); it usually needs rapid and careful reassessment and often equally urgent intervention. The resulting problems and treatment required can dominate a patient’s management, making it particularly important to consider principles by which surgical support can be optimized. In particular, good communication, careful assessment and reassessment, meticulous planning and attention to sound surgical techniques are all important.