F Weber1, U Schuss2, C Sittel2. 1. Klinik für Hals‑, Nasen‑, Ohrenkrankheiten, Plastische Operationen, Klinikum Stuttgart, Kriegsbergstr. 60, 70174, Stuttgart, Deutschland. f.weber@klinikum-stuttgart.de. 2. Klinik für Hals‑, Nasen‑, Ohrenkrankheiten, Plastische Operationen, Klinikum Stuttgart, Kriegsbergstr. 60, 70174, Stuttgart, Deutschland.
Abstract
BACKGROUND: Incurable head and neck cancer causes distressing symptoms that significantly reduce patients' quality of life. OBJECTIVE: The aim of this article is to present the surgical possibilities and their limitations in a palliative setting. MATERIALS AND METHODS: A literature review was performed and supplemented with the authors' own experiences. RESULTS: Smaller endoscopic procedures for tumor debulking or hemostasis are possible to reduce symptoms and improving quality of life, which should be the aim of palliative care. To preserve swallowing function and breathing, the insertion of stents is a feasible alternative to tracheotomy. However, even larger tumor resections with reconstruction by pedicled or free grafts may be justified. CONCLUSION: Especially in the palliative setting, patients and their individual complaints are the primary focus. Therefore, the indications for surgery should be discussed with the patient and his relatives, preferentially interdisciplinarily. Due to considerable progress, particularly in the field of systemic tumor therapy, extended surgical procedures with reconstruction are losing some of their importance in the palliative situation.
BACKGROUND: Incurable head and neck cancer causes distressing symptoms that significantly reduce patients' quality of life. OBJECTIVE: The aim of this article is to present the surgical possibilities and their limitations in a palliative setting. MATERIALS AND METHODS: A literature review was performed and supplemented with the authors' own experiences. RESULTS: Smaller endoscopic procedures for tumor debulking or hemostasis are possible to reduce symptoms and improving quality of life, which should be the aim of palliative care. To preserve swallowing function and breathing, the insertion of stents is a feasible alternative to tracheotomy. However, even larger tumor resections with reconstruction by pedicled or free grafts may be justified. CONCLUSION: Especially in the palliative setting, patients and their individual complaints are the primary focus. Therefore, the indications for surgery should be discussed with the patient and his relatives, preferentially interdisciplinarily. Due to considerable progress, particularly in the field of systemic tumor therapy, extended surgical procedures with reconstruction are losing some of their importance in the palliative situation.
Entities:
Keywords:
Bleeding; Head and neck neoplasms; Pain; Palliative surgery; Stents
Authors: R D van der Bogt; B D Vermeulen; A N Reijm; P D Siersema; M C W Spaander Journal: Best Pract Res Clin Gastroenterol Date: 2018-11-22 Impact factor: 3.043
Authors: Emily Marchiano; Dhruv M Patel; Tapan D Patel; Amit A Patel; Yuhan E Xue; Jean Anderson Eloy; Soly Baredes; Richard Chan W Park Journal: Otolaryngol Head Neck Surg Date: 2015-11-25 Impact factor: 3.497