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The outcomes of palliative surgical treatment in a context of rising incidence of gastro intestinal cancers in Burkina Faso, Africa

      Abstract

      Background and objectives

      Digestive cancers are frequent and of late diagnosis in Africa. Palliative surgery therefore plays an important role. Our objective is to describe its indications, techniques and results in primary digestive cancers.

      Methods

      Retrospective, bicentric, descriptive study of palliative surgery for primary digestive cancer, performed in Ouagadougou over the last twelve years. The results were assessed according to the degree of improvement in the patients' quality of life. We divided the patients into four groups according to the improvement of the quality of life after the operation. The results were considered very satisfactory when the symptoms disappeared completely. They were considered satisfactory when the symptoms decreased in intensity. They were unsatisfactory when the symptoms kept the same intensity. They were considered poor when the symptoms persisted with greater intensity.

      Results

      Six hundred and thirty-nine palliative digestive cancer surgeries were performed. All patients had clinical symptoms deteriorating their quality of life (56.7%) or even a surgical emergency (43.3%). Biliodigestive diversion, gastroentero-anastomosis and colostomy were the palliative procedures performed respectively in 26.6%, 16.9%, and 34.1%. Complications were noted in 11.7%. These were digestive fistulas in 9 cases, retraction and stomal prolapse in 11 cases. The improvement of the quality of life was very satisfactory in 76%.

      Conclusions

      Palliative surgery is widely practiced in digestive cancers. It improves the quality of life. African surgeons should be aware and well-educated to safely perform surgical palliative procedures.

      Keywords

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      References

        • Sung H.
        • Ferlay J.
        • Siegel R.L.
        • Laversanne M.
        • Soerjomataram I.
        • Jemal A.
        • et al.
        Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.
        CA A Cancer J Clin. 2021; 71: 209-249https://doi.org/10.3322/caac.21660
        • Zongo N.
        • Ouedraogo M.N.L.
        • Bague A.H.
        • Yameogo P.B.
        • Windsouri M.
        • Kambou A.
        • et al.
        Epidémiologie descriptive des cancers digestifs au Burkina Faso. A propos de 2536 cas.
        J Afr Chir Digest. 2021; 21 (ISSN: 2415 – 2307): 3205-3210
        • Moroney M.R.
        • Lefkowits C.
        Evidence for integration of palliative care into surgical oncology practice and education.
        J Surg Oncol. 2019; 120: 17-22https://doi.org/10.1002/jso.25454
        • Nomikos I.N.
        Palliative surgery. What is it?.
        Hellenic J Surg. 2018; 90: 65-68https://doi.org/10.1007/s13126-018-0442-6
        • WHO. Definition of palliative care
        World health organization.
        (Available at:)
        http://www.who.int/cancer/palliative/definition/en/
        Date: 2008
        Date accessed: June 17, 2021
        • Hanna J.
        • Blazer D.G.
        • Mosca P.J.
        Overview of palliative surgery: principles and priorities.
        J Palliat Care Med. 2012; 2: 132https://doi.org/10.4172/2165-7386.1000132
        • Folkert I.W.
        • Roses R.E.
        Value in palliative cancer surgery: a critical assessment.
        J Surg Oncol. 2016; 114: 311-315https://doi.org/10.1002/jso.24303
        • Bridget N.F.
        Understanding the surgeons' role in palliation of the oncology.
        Surg Oncol Clin N Am. 2021; 30: 25-26https://doi.org/10.1016/j.soc.2021.03.004
      1. Paiva FP, Santos TCF, Aperibense PGGS, Martins GCS, Ennes LD, Almeida Filho AJ. Historical aspects in pain management in palliative care in an oncological reference unit.

        • Ayoade B.
        • Oyelekan A.
        • Fatungase O.
        • Nwokoro C.
        • Salami B.
        • Adekoya A.
        Palliative surgery for cancer in southwest Nigeria.
        Ann Afr Surg. 2019; 16: 55-58https://doi.org/10.4314/aas.v16i2.3
        • Miner T.J.
        • Jaques D.P.
        • Shriver C.
        Decision making on surgical palliation based on patient outcome data.
        J Am Coll Surg. 1999; 177: 150-154https://doi.org/10.1016/s0002-9610(98)00323-7
        • Zongo N.
        • Sanou A.
        • Ouédraogo S.
        • Djiwa F.
        • Ouangré E.
        • Zida M.
        • et al.
        Cancers digestifs primitifs du sujet âgé : particularités épidémiologiques dans un pays à faible espérance de vie : cas du Burkina Faso.
        Le Journal Français d’oncogeriatrie. 2015; 6 (ISSN 2107-6669): 91-96
        • Barbas A.S.
        • Zani S.
        Education, training, and certification in palliative surgery and surgical palliative care.
        J Palliat Care Med. 2012; S2: 2https://doi.org/10.4172/2165-7386.S2-002
        • Edwards M.J.
        Access to quality cancer care: consensus statement of the American. Federation of Clinical Oncologic Societies.
        Ann Surg Oncol. 1998; 5: 657-659https://doi.org/10.1007/BF02303837
        • Smith J.T.
        • Temin S.
        • Alesi E.R.
        • Abernethy A.P.
        • Balboni T.A.
        • Basch E.M.
        • et al.
        American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncologycare.
        J Clin Oncol. 2012; 30 (Rev Bras Enferm. 2021;74(5):e20200761. DOI: 10.1590/0034-7167-2020-0761): 880-887https://doi.org/10.1200/JCO.2011.38.5161
        • Easson A.M.
        • Asch M.
        • Swallow C.J.
        Palliative general surgical procedures.
        Surg Oncol Clin N Am. 2001; 10: 161-184https://doi.org/10.1016/S1055-3207(18)30091-7
        • Timothy M.P.
        Palliative care in surgical oncology.
        Surg Oncol Clin N Am. 2021; 30: 13https://doi.org/10.1016/j.soc.2021.03.00
        • Cady B.
        • Miner T.
        • Morgentaler A.
        Palliative care symposium. Part 2: surgical palliation of advanced illness: what's new, what's helpful.
        J Am Coll Surg. 2005; 200: 281-285https://doi.org/10.1016/j.jamcollsurg.2004.10.007
        • Ayoade B.
        • Oyelekan A.
        • Fatungase O.
        • Nwokoro C.
        • Salami B.
        • Adekoya A.
        Palliative surgery for cancer in southwest Nigeria.
        Ann Afr Surg. 2019; 16https://doi.org/10.4314/aas.v16i2.3
        • Badgwell B.D.
        • Aloia T.A.
        • Garrett J.
        • Chedister G.
        • Tom Miner T.
        • Krouse R.
        Indicators of symptom improvement and survival in inpatients with advanced cancer undergoing palliative surgical consultation.
        J Surg Oncol. 2012; 107: 367-371https://doi.org/10.1002/jso.23236
        • Grudzen C.R.
        • Richardson L.D.
        • Johnson P.N.
        • et al.
        Emergency department–initiated palliative care in advanced cancer: a randomized clinical trial.
        JAMA Oncol. 2016; 2 (1): 591-598https://doi.org/10.1001/jamaoncol.2015.5252
        • Dunn G.P.
        • Martensen R.
        • Weissman D.
        Palliative surgery: definition, principles, outcomes, assessments.
        in: Dunn G.P. Martensen R. Weissman D. Surgical palliative care: a resident's guide. Chicago, IL 60611-3211, Cunniff-Dixon Foundation. American College of Surgeons, 2009: 131-140