Marom Tal, Segal David, Erlich Tomer, Tsumi Erez, Merin Ofer, Lin Guy
Israel Defense Forces Medical Corps Field Hospital, Tel Hashomer, Israel; Department of Otolaryngology - Head & Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler School of Medicine, Holon, Israel.
Israel Defense Forces Medical Corps Field Hospital, Tel Hashomer, Israel; Department of Military Medicine, Hebrew University Faculty of Medicine, Jerusalem, Israel.
Am J Disaster Med. 2014 Summer;9(3):211-9. doi: 10.5055/ajdm.2014.0172.
To describe clinical and ethical dilemmas in patients presenting with head and neck (H&N) tumors to a field hospital in the "subacute" period following a typhoon.
We retrospectively reviewed charts of H&N patients presenting to an integrated Israeli-Filipino medical facility, which was operated more than 11 days.
Of the 1,844 adult patients examined, 85 (5 percent) presented with H&N tumors. Of those, 70 (82 percent) were females, with a mean age of 43 ± 15 years. Thyroid neoplasms were the most common tumors (68, 80 percent). Despite limited resources, we contributed to the workup and treatment of several patients. To better illustrate our dilemmas, we present four key patients, in whom we favored diagnostic/therapeutic interventions in two, and opted to defer any intervention in two.
In a relief mission, despite the lack of clinical and pathological staging and questionable continuity of care, surgical interventions can be considered for therapeutic, palliative, and diagnostic purposes.
描述台风过后“亚急性期”前往野战医院就诊的头颈部（H&N）肿瘤患者所面临的临床和伦理困境。
我们回顾性分析了前往一家由以色列和菲律宾联合运营且运营超过11天的医疗机构就诊的H&N患者的病历。
在1844名接受检查的成年患者中，85名（5%）患有H&N肿瘤。其中，70名（82%）为女性，平均年龄为43±15岁。甲状腺肿瘤是最常见的肿瘤（68例，80%）。尽管资源有限，我们仍为几名患者的检查和治疗提供了帮助。为更好地说明我们所面临的困境，我们介绍四名关键患者，其中两名我们倾向于进行诊断/治疗干预，另外两名则选择推迟任何干预。
在救援任务中，尽管缺乏临床和病理分期且护理的连续性存疑，但仍可考虑出于治疗、姑息和诊断目的进行手术干预。
