• Title/Summary/Keyword: Palliation

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Concept Analysis of Palliation (완화(palliation)의 개념분석)

  • Yoon, Soo-Jin;Choi, Euy-Soon
    • Women's Health Nursing
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    • v.12 no.1
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    • pp.5-11
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    • 2006
  • Purpose: The purpose of this study was to analyze the concept, palliation, in order to enhance understanding of palliative care and ultimately lead to the provision of timely quality palliative care. Method: This study used Walker and Avant s methods for concept analysis. Result: The defining attributes of palliation identified in this study were 1) being limited, 2) responsiveness, 3) leading to positive effects, 4) relativity, and 5) being unsettled. The antecedents of palliation were 1) a problematic condition, 2) appropriate management for the problematic condition, and 3) interaction between the problematic condition and the appropriate management. The consequences of palliation included 1) improvement of a problematic condition and 2) dependency on a management of the problematic condition. Conclusion: Although further studies are required to refine the diverse attributes of the concept of palliation, according to this concept analysis of palliation, palliative care should be introduced at the early stage of disease and constantly provided for the improvement of its negative symptoms.

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Staged Repair after Hybrid Palliation for Interrupted Aortic Arch with Systemic Outflow Tract Obstruction

  • Lee, June;Kim, Yong Han;Lee, Cheul
    • Journal of Chest Surgery
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    • v.52 no.1
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    • pp.32-35
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    • 2019
  • Surgical management of interrupted aortic arch (IAA) with systemic outflow tract obstruction is clearly a challenge. If both ventricles are adequate, the Yasui operation is a useful option. Otherwise, a staged approach through initial hybrid palliation and delayed biventricular repair, tailored to the degree of obstructed outflow, serves to avoid a high-risk neonatal procedure. Herein, we present a patient with IAA and severe systemic outflow tract obstruction whose treatment involved hybrid palliation, followed by a Yasui operation.

Comparing palliative treatment options for cholangiocarcinoma: photodynamic therapy vs. radiofrequency ablation

  • Tayyaba Mohammad;Michel Kahaleh
    • Clinical Endoscopy
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    • v.55 no.3
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    • pp.347-354
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    • 2022
  • Referral to an endoscopist is often done once curative resection is no longer an option for cholangiocarcinoma management. In such cases, palliation has become the main objective of the treatment. Photodynamic therapy and radiofrequency ablation can be performed to achieve palliation, with both procedures associated with improved stent patency and survival. Despite the greatly increased cost and association with photosensitivity, photodynamic therapy allows transmission to the entire biliary tree. In contrast, radiofrequency ablation is cheaper and faster to apply, but requires intraductal contact. This paper reviews both modalities and compares their efficacy and safety for bile duct cancer palliation.

Initial Palliation of the Pulmonary Atresia with Interventricular Communication (심실간 중격결손을 동반한 폐동맥 폐쇄증의 일차 고식적 수술)

  • 김삼현
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.23-31
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    • 1992
  • The ideal approach in the staged management of patients with pulmonary atresia has been a challenging problem and the result has not been always satisfactory. We reviewed our early result of initial palliative surgeries in fifteen cases of pulmonary atresia with interventricular communication Included are eight cases of simple pulmonary atresia with ventricular septal defect and seven cases of pulmonary atresia associated with other complex cardiac anomalies. The ages of the patients were less than one year except one. The morphology of pulmonary vasculature was highly variable and showed unfavorable conditions in most cases. Pulmonary artery was nonconfluent in two. Two-thirds of all cases showed significant problems such as juxtaductal stenosis or diffuse hypoplasia. The ductus arteriosus usually narrowed at its pulmonic end. Initial palliation was done by modified Blalock-Taussig shunt in six, central shunt with or without pulmonary angioplasty in five, right ventricular outflow tract [RVOT] reconstruction in three and direct connection of nonconfluent pulmonary arteries with bilateral cav-opulmonary shunt in one patient. There were 3 hospital deaths. Two of them underwent simultaneous repair of the associated anomaly of TAPVR. Among the six patients who received modified Blalock-Taussig shunt, three needed early second palliative procedure by central shunt, RVOT patch reconstruction and pulmonary angioplasty in each case, All patients who received central shunt showed marked clinical improvement. Among the twelve patients who survived the palliative procedures, two patients underwent total correction 13 months and 18 months after initial palliation respectively. We think that the choice of palliative procedure must be individualized according to the morphology of the pulmonary arteries. More experience and long term follow-up data are necessary to meet this challenging problem.

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Outcome of neonatal palliative procedure for pulmonary atresia with ventricular septal defect or tetralogy of Fallot with severe pulmonary stenosis: experience in a single tertiary center

  • Jo, Tae Kyoung;Suh, Hyo Rim;Choi, Bo Geum;Kwon, Jung Eun;Jung, Hanna;Lee, Young Ok;Cho, Joon Yong;Kim, Yeo Hyang
    • Clinical and Experimental Pediatrics
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    • v.61 no.7
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    • pp.210-216
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    • 2018
  • Purpose: The present study aimed to evaluate progression and prognosis according to the palliation method used in neonates and early infants aged 3 months or younger who were diagnosed with pulmonary atresia with ventricular septal defect (PA VSD) or tetralogy of Fallot (TOF) with severe pulmonary stenosis (PS) in a single tertiary hospital over a period of 12 years. Methods: Twenty with PA VSD and 9 with TOF and severe PS needed initial palliation. Reintervention after initial palliation, complete repair, and progress were reviewed retrospectively. Results: Among 29 patients, 14 patients underwent right ventricle to pulmonary artery (RV-PA) connection, 11 palliative BT shunt, 2 central shunt, and 2 ductal stent insertion. Median age at the initial palliation was 13 days (1-98 days). Additional procedure for pulmonary blood flow was required in 5 patients; 4 additional BT shunt operations and 1 RV-PA connection. There were 2 early deaths among patients with RV-PA connection, one from RV failure and the other from severe infection. Finally, 25 patients (86%) had a complete repair. Median age of total correction was 12 months (range, 2-31 months). At last follow-up, 2 patients had required reintervention after total correction; 1 conduit replacement and 1 right ventricular outflow tract (RVOT) patch enlargements. Conclusion: For initial palliation of patients with PA VSD or TOF with severe PS, not only shunt operation but also RV-PA connection approach can provide an acceptable outcome. To select the most proper surgical strategy, we recommend thorough evaluation of cardiac anomalies such as RVOT and PA morphologies and consideration of the patient's condition.

177Lu-EDTMP radiation absorbed dose evaluation in man based on biodistribution data in Wistar rats

  • Reza Bagheri
    • Nuclear Engineering and Technology
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    • v.55 no.1
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    • pp.254-260
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    • 2023
  • Skeletal metastases are common in patients suffering from various primary cancers. Radiopharmaceuticals are an effective option for bone pain palliation. In this work, the radiation absorbed dose of 177Lu-EDTMP radiopharmaceutical was estimated for adult man based on biodistribution data in Wistar rats. The MIRD dose calculation method and the Sparks and Aydogan methodology were applied. The results shows that about 46% of injected activity is cumulated on the surface of the trabecular and cortical bones. Radiation absorbed doses of red bone marrow and osteogenic cells were estimated to about 1.1 and 6.2 mGy/MBq, respectively. The maximum administrated activity was obtained 27 MBq/kg of body weight with an effective dose of 0.23 mSv/MBq. The results were compared with other available data from literature. This study indicated that 177Lu-EDTMP provides therapeutic efficacy for achieving bone pain palliation with low undesired dose to other normal organs.

Intracavitary Irradiation of Locally Advanced Recurrent Adenocarcinoma of Rectum Along the Fistula Tract (누도를 따라 재발한 직장암의 강내조사)

  • Kim Kyeong Ae;Kim Sung Kyu;Shin Sei One;Kim Myung Se;Song Sun Kyuo;Shim Min Chul;Kwun Koing Bo
    • Radiation Oncology Journal
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    • v.6 no.2
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    • pp.289-293
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    • 1988
  • Radiation therapy has been used as adjuvant therapy or primary treatment for inoperable, remnant or recurrent cancer. Many authors reported good palliation effect by external irradiation or interstitial therapy, but the report of intracavitary irradiation for recurrent, inoperable rectal cancer is very rare. We experienced a case of recurrent adenocarcinoma of rectum along fistula tract after laparotomy and postoperative radiotherapy who achieved very good palliation by intracavitary irradiation. Even though we have only good palliation without impressive survival improvement in this case, we hope that this technique may achieve good local control In other similar patients.

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