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CC BY-NC-ND 4.0 · Indian J Plast Surg 2012; 45(01): 016-021
DOI: 10.4103/0970-0358.96571
Original Article
Association of Plastic Surgeons of India

Aggressive surgical palliation for advanced girdle tumours

Andrew Burd
Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital
,
KC Wong
Division of Orthopaedic Oncology, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Prince of Wales Hospital
,
Shekhar M. Kumta
Division of Orthopaedic Oncology, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Prince of Wales Hospital
› Author Affiliations
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Publication History

Publication Date:
31 December 2019 (online)

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ABSTRACT

Background: The surgical management of advanced, incurable, malignant disease presents particular ethical and technical challenges. The clear goal is palliation and the surgical futility must be avoided. This case series presents some particular challenges in end-of-life surgery. Materials and Methods: Fifteen patients referred with advanced malignant disease involving a limb girdle were reviewed. Results: In one case, a patient pleaded for surgery after initially requesting a delay to seek treatment from a Chinese Traditional Herbalist. The increase in tumour bulk led to problems with surgery and the patient died in a hospital a few weeks later. This case illustrates ′futility′ not recognized and encountered. The remaining 14 patients exhibited positive palliation with improved quality of dying and appreciation expressed by patients, relatives and staff. Conclusion: In selected cases, with a skilled and experienced surgical team, patients with advanced malignant disease can still benefit from aggressive surgical palliation. The margin of error is small between palliation being attempted and futility being achieved. This considerably adds to the challenge of end-of-life surgery.

KEY WORDS

Futility - palliation - quality of life - surgery
 
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