Department of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
Section of Gastrointestinal Surgical Oncology, Peritoneal Surface Malignancy Program, Division of Surgical Oncology, Johns Hopkins University, Baltimore, MD, USA.
Ann Palliat Med. 2022 Nov;11(11):3530-3541. doi: 10.21037/apm-22-770. Epub 2022 Nov 2.
Palliative interventions have known benefits in the care of surgical patients with advanced illness. However, the literature supporting the routine use and implementation of palliative care in the context of surgery is limited. The primary aim of this review was to explore the literature that has been published in the field of surgical palliative care since 2016. The secondary aim of this analysis was to categorize updates in literature in three foundational domains (I) measuring outcomes that matter to patients; (II) communication and decision making; and (III) delivery of palliative care to surgical patients.
This analysis included citations from PubMed, EMBASE, PsychINFO, and CINAHL, circulated between 01/01/2016 and 22/02/2022 that studied palliative care interventions for surgical patients. Additional articles were included following a manual review of citations and publications from the Annals of Palliative Medicine.
A total of 3,258 unique articles were identified through the database search, and eight additional studies were identified from manual review. Twenty-two articles were included in the final narrative review: seven addressed the first foundational domain, three explored the second, and twelve summarized developments in the third.
With advances in clinical opportunities to support seriously ill patients, the adoption of palliative care frameworks in surgical settings is essential to achieving value-concordant care. Though the literature studying the delivery of palliative care for surgical patients is slowly expanding, additional work is needed to optimize pre and post-operative patient engagement in complex decision making, align surgical treatments with patient-oriented outcomes, and integrate palliative care principles into routine surgical practice.
姑息干预措施已被证实可改善晚期疾病手术患者的护理效果。然而，支持在外科手术背景下常规使用和实施姑息治疗的文献有限。本研究的主要目的是探索自 2016 年以来发表的外科姑息治疗领域的文献。本次分析的次要目的是将文献中的更新内容分为三个基础领域进行分类：（I）衡量对患者重要的结果；（II）沟通和决策；以及（III）为外科患者提供姑息治疗。
本分析纳入了 2016 年 1 月 1 日至 2022 年 2 月 22 日期间在 PubMed、EMBASE、PsychINFO 和 CINAHL 上发表的研究外科患者姑息治疗干预措施的引文。此外，还通过对《姑息医学年鉴》的引文和出版物进行手动审查，纳入了其他文章。
通过数据库搜索共确定了 3258 篇独特的文章，通过手动审查又确定了 8 篇额外的文章。最终有 22 篇文章被纳入了叙事综述：7 篇文章涉及第一个基础领域，3 篇文章探讨了第二个领域，12 篇文章总结了第三个领域的发展。
随着为支持重病患者提供临床机会的进步，在外科环境中采用姑息治疗框架对于实现符合价值的护理至关重要。尽管研究外科患者姑息治疗的文献正在缓慢扩展，但仍需要进一步的工作来优化复杂决策中的术前和术后患者参与度，使外科治疗与以患者为导向的结果保持一致，并将姑息治疗原则整合到常规外科实践中。
