1 Division of Gastroenterology, Department of Medicine, Duke University , Durham, North Carolina.
2 Duke Cancer Institute , Duke Fuqua School of Business, Durham, North Carolina.
J Palliat Med. 2018 Sep;21(9):1339-1343. doi: 10.1089/jpm.2018.0251. Epub 2018 Jun 15.
Patients diagnosed with advanced stages of gastrointestinal (GI) malignancies are often quite symptomatic, with symptoms primarily related to anatomic sites of obstruction. Endoscopic approaches to the palliation of GI malignancies have begun to overtake surgical approaches as first line in interventional management. We brought together a team of interventional gastroenterologists and palliative care experts to collate practical pearls for the types of endoscopic interventions used for symptom management in patients with GI malignancies. In this article, we use a "Top 10" format to highlight issues that may help palliative care physicians recognize common presentations of advanced GI malignancies, address interventional approaches to improve symptom burden, and improve the quality of shared decision making and goals-of-care discussions.
患有晚期胃肠道(GI)恶性肿瘤的患者通常症状明显,主要与梗阻的解剖部位有关。内镜治疗方法已开始逐渐取代手术方法,成为介入治疗管理的一线治疗方法。我们汇集了一组介入胃肠病学家和姑息治疗专家,以收集用于胃肠道恶性肿瘤患者症状管理的内镜干预类型的实用技巧。在本文中,我们使用“十大”格式来突出可能有助于姑息治疗医生识别晚期胃肠道恶性肿瘤常见表现的问题,探讨介入方法以减轻症状负担,并提高共享决策和目标治疗讨论的质量。