Dunn Geoffrey P
Department of Surgery, Hamot Medical Center, 2050 South Shore Drive, Erie, PA 16505, USA.
Curr Oncol Rep. 2002 May;4(3):233-41. doi: 10.1007/s11912-002-0021-3.
Despite many valuable technical innovations for the relief of suffering in advanced disease over the past few years, only recently have surgical oncologists attempted to more clearly define palliation. Previous definitions have been misleading, creating confusion about the merits of surgery in many situations and difficulty in posing questions for future prospective clinical trials. This report outlines recent progress in identifying and refining a philosophy of palliative surgery that would align it with the consensus of nonsurgical opinion summarized by the 1990 World Health Organization definition of palliative care and the emerging consensus among the medical specialties in the United States concerning principles of care at the end of life. Selected controversies and recent innovations, as well as guidelines for palliative surgery, are discussed.
尽管在过去几年里出现了许多有价值的技术创新，用于缓解晚期疾病患者的痛苦，但直到最近，外科肿瘤学家才开始尝试更明确地界定姑息治疗。以往的定义具有误导性，在许多情况下造成了人们对手术价值的困惑，也给未来前瞻性临床试验的问题提出带来了困难。本报告概述了在确定和完善姑息性手术理念方面的最新进展，这种理念将使其与1990年世界卫生组织姑息治疗定义所总结的非手术观点的共识以及美国各医学专科之间就临终护理原则达成的新共识保持一致。文中还讨论了一些选定的争议、近期的创新以及姑息性手术指南。
