Palliative surgery

Palliative surgery is defined as surgery for symptoms attributable to an advanced or incurable malignancy or symptoms due to treatment of malignancy. Palliative surgery is a frequent occurrence at cancer centers and represents almost a quarter of a surgical oncologist's practice. Common indications for palliative surgical consultation include gastrointestinal obstruction, gastrointestinal bleeding, obstructive jaundice, wound problems, bowel perforation, ascites, and abdominal pain. Palliative surgical consultation requires a different approach than non-palliative surgery consultation. The benefits of palliative surgery are primarily focused on improvements in symptoms and quality of life. The risks of palliative surgery are significant, with frequent reports of morbidity and mortality of 30% and 10%, respectively. Palliative surgical consultation therefore requires the highest degree of surgical decision-making. This chapter will discuss the frequent indications for palliative surgery, management options, surgical interventions, and variables associated with outcome.