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The palliative triangle: improved patient selection and outcomes associated with palliative operations
Thomas J Miner1, Jonah Cohen, Kevin Charpentier
1Department of Surgery, The Alpert Medical School of Brown University, Rhode Island Hospital, 593 Eddy St, APC 4, Providence, RI 02903, USA. tminer@usasurg.org
Archives of Surgery (Chicago, Ill. : 1960)
|May 18, 2011
Summary
The palliative triangle method effectively selects patients for palliative operations, leading to significant symptom improvement. This careful patient selection for palliative surgery resulted in better outcomes and fewer complications.
Area of Science:
- Surgical Oncology
- Palliative Care
- Oncology
Background:
- Palliative operations aim to alleviate symptoms in advanced cancer patients.
- Effective patient selection is crucial for successful palliative surgical outcomes.
Purpose of the Study:
- To evaluate the outcomes of patients managed with the palliative triangle method.
- To identify factors associated with effective patient selection for palliative surgery.
Main Methods:
- Prospective identification of 227 patients with advanced incurable cancer undergoing palliative care consultations.
- Application of the palliative triangle technique for patient selection for palliative operations.
- Assessment of symptom resolution, overall survival, and postoperative complications.
Main Results:
- 106 patients underwent palliative operations for gastrointestinal obstruction, tumor-related symptoms, or jaundice.
- Patient-reported symptom resolution or improvement was achieved in 90.7% of 129 procedures.
- Palliative procedures were associated with 30-day postoperative morbidity (20.1%) and mortality (3.9%), with a median survival of 212 days.
Conclusions:
- Palliative operations, when performed in carefully selected patients using the palliative triangle method, yield significantly better symptom resolution.
- This approach is associated with fewer postoperative complications compared to previously published data.
- The palliative triangle method aids in optimizing patient selection for palliative surgical interventions.
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