How Should Surgical Palliative Success Be Defined?

The goal of palliative surgery is to improve quality of life through symptom relief, functional support, and patient autonomy. Surgeons are often hesitant to practice palliative surgical care given a lack of scientific guidance and conflicting principles of physician duty. It is important for future studies to be sure to distinguish between pre- and intra-operatively established palliative surgery. Additionally, palliative care education for both surgeons and residents is essential to changing the culture of surgical rescue and for broader acceptance of surgical palliative techniques. Surgical palliative success can be assessed in various ways, depending on the context, goals, and values of the patient. The general goal is to improve the quality of life of patients who are suffering from a serious illness or condition, and for whom curative treatments are not possible. Quality of life assessments can be done by various, methodically developed patient questionnaires and statistical analysis of length of hospital stays and rates of readmission and complications. Perhaps the most insightful measure of patient satisfaction is by simply asking them whether or not it was worth it. In cases where palliative surgery does not meet expectations, this should not be deduced as failure to attempt rescue but as a success in eliciting and honoring patient preferences for end-of-life care.