{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T23:37:16Z","timestamp":1766187436426,"version":"3.48.0"},"reference-count":52,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Colon Rectal Surg"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Inoperable complications from pelvic surgery or the progression of unresectable colorectal neoplasms may create a situation requiring a focus on quality of life over cure within a palliative care framework. This review outlines management strategies for some common, incurable, long-term sequelae patients of colorectal surgeons may experience, including advanced cancer-causing obstruction, bleeding, and pain; chronic anastomotic leak after pelvic surgery, including salvage techniques; and chronic pelvic pain after surgery. Strategies include palliative operations, endoscopic and minimally invasive techniques, and unique approaches to pain control and symptom management. The paper also reviews evidence on the benefit of palliative care specialists, when such specialists may be beneficial, as well as how the colorectal surgeon may facilitate decision-making in treatment decisions of incurable disease.<\/jats:p>","DOI":"10.1055\/s-0045-1807756","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T18:50:31Z","timestamp":1745261431000},"page":"089-094","source":"Crossref","is-referenced-by-count":0,"title":["Palliation for Inoperable Infectious and Neoplastic Long-Term Surgical Complications"],"prefix":"10.1055","volume":"39","author":[{"given":"Peter A.","family":"Bryant","sequence":"additional","affiliation":[{"name":"Department of Surgery, Vanderbilt University Medical Center, Medical Center North, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Myrick C.","family":"Shinall","sequence":"additional","affiliation":[{"name":"Department of Surgery, Vanderbilt University Medical Center, Geriatrics Research, Education, and Clinical Center, VA Tennessee Valley Healthcare System, Medical Center North, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,4,21]]},"reference":[{"issue":"10","key":"ref1","doi-asserted-by":"crossref","first-page":"e569","DOI":"10.1111\/codi.12314","article-title":"Nonresectional management of colorectal cancer: multidisciplinary factors that influence treatment strategy","volume":"15","author":"P S Turner","year":"2013","journal-title":"Colorectal Dis"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.gassur.2003.11.020","article-title":"Palliative therapy of rectal cancer. Overview: epidemiology, indications, goals, extent, and nature of work-up","volume":"8","author":"D A Rothenberger","year":"2004","journal-title":"J Gastrointest Surg"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1001\/archsurg.135.5.530","article-title":"Initial presentation with stage IV colorectal cancer: how aggressive should we be?","volume":"135","author":"S A Rosen","year":"2000","journal-title":"Arch Surg"},{"issue":"21","key":"ref4","doi-asserted-by":"crossref","first-page":"4361","DOI":"10.1200\/JCO.2002.02.121","article-title":"Pain and quality of life after treatment in patients with locally recurrent rectal cancer","volume":"20","author":"N F Esnaola","year":"2002","journal-title":"J Clin Oncol"},{"issue":"07","key":"ref5","doi-asserted-by":"crossref","first-page":"835","DOI":"10.3748\/wjg.v17.i7.835","article-title":"Management of stage IV rectal cancer: palliative options","volume":"17","author":"S M Ronnekleiv-Kelly","year":"2011","journal-title":"World J Gastroenterol"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.suronc.2007.08.008","article-title":"Palliation of colorectal cancer","volume":"16","author":"N Wasserberg","year":"2007","journal-title":"Surg Oncol"},{"issue":"11","key":"ref7","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1097\/DCR.0000000000000679","article-title":"Palliative pelvic exenteration: clinical outcomes and quality of life","volume":"59","author":"A J Quyn","year":"2016","journal-title":"Dis Colon Rectum"},{"issue":"08","key":"ref8","first-page":"CD008997","article-title":"Non-resection versus resection for an asymptomatic primary tumour in patients with unresectable stage IV colorectal cancer","volume":"2012","author":"R Cirocchi","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1245\/s10434-006-9146-1","article-title":"Asymptomatic colorectal cancer with un-resectable liver metastases: immediate colorectal resection or up-front systemic chemotherapy?","volume":"14","author":"A Muratore","year":"2007","journal-title":"Ann Surg Oncol"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1007\/s00384-003-0551-7","article-title":"Non-curative surgery for colorectal cancer: critical appraisal of outcomes","volume":"19","author":"W L Law","year":"2004","journal-title":"Int J Colorectal Dis"},{"issue":"09","key":"ref12","doi-asserted-by":"crossref","first-page":"e825","DOI":"10.1097\/CCM.0000000000003299","article-title":"Clinical Practice Guidelines for the prevention and management of pain, agitation\/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU","volume":"46","author":"J W Devlin","year":"2018","journal-title":"Crit Care Med"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1007\/s00595-013-0665-7","article-title":"Palliative treatment of malignant colorectal obstruction caused by advanced malignancy: a self-expanding metallic stent or surgery? A system review and meta-analysis","volume":"44","author":"T W Liang","year":"2014","journal-title":"Surg Today"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.amjsurg.2011.11.013","article-title":"Palliative management for patients with subacute obstruction and stage IV unresectable rectosigmoid cancer: colostomy versus endoscopic stenting: final results of a prospective randomized trial","volume":"204","author":"E Fiori","year":"2012","journal-title":"Am J Surg"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"E558","DOI":"10.1055\/a-0591-2883","article-title":"Colonic stent versus emergency surgery as treatment of malignant colonic obstruction in the palliative setting: a systematic review and meta-analysis","volume":"6","author":"I B Ribeiro","year":"2018","journal-title":"Endosc Int Open"},{"issue":"03","key":"ref16","doi-asserted-by":"crossref","first-page":"151","DOI":"10.4236\/ss.2011.23032","article-title":"Self-expanding metal stenting for malignant colonic tumours: a prospective study","volume":"2","author":"W Al-Jundi","year":"2011","journal-title":"Surg Sci"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/030089160108700101","article-title":"The role of somatostatin and octreotide in bowel obstruction: pre-clinical and clinical results","volume":"87","author":"C Ripamonti","year":"2001","journal-title":"Tumori"},{"issue":"02","key":"ref18","doi-asserted-by":"crossref","first-page":"95","DOI":"10.4103\/1319-3767.93808","article-title":"Percutaneous endoscopic gastrostomy tube placement for end-stage palliation of malignant gastrointestinal obstructions","volume":"18","author":"A Teriaky","year":"2012","journal-title":"Saudi J Gastroenterol"},{"issue":"24","key":"ref19","doi-asserted-by":"crossref","first-page":"7602","DOI":"10.3748\/wjg.v20.i24.7602","article-title":"Palliative care and end-stage colorectal cancer management: the surgeon meets the oncologist","volume":"20","author":"R Costi","year":"2014","journal-title":"World J Gastroenterol"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/1748-717X-6-52","article-title":"Palliative radiotherapy in patients with a symptomatic pelvic mass of metastatic colorectal cancer","volume":"6","author":"S H Bae","year":"2011","journal-title":"Radiat Oncol"},{"issue":"07","key":"ref21","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1089\/jpm.2019.0139","article-title":"Management of malignant rectal pain and tenesmus: a systematic review","volume":"23","author":"K Mueller","year":"2020","journal-title":"J Palliat Med"},{"issue":"04","key":"ref22","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1002\/1096-9098(200012)75:4<280::AID-JSO13>3.0.CO;2-Q","article-title":"Pelvic cancer pain","volume":"75","author":"B M Rigor Sr","year":"2000","journal-title":"J Surg Oncol"},{"issue":"01","key":"ref23","first-page":"93","article-title":"WHO guidelines for the use of analgesics in cancer pain","volume":"7","author":"V Ventafridda","year":"1985","journal-title":"Int J Tissue React"},{"issue":"10","key":"ref24","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1177\/0269216317697897","article-title":"A systematic review of the effectiveness of palliative interventions to treat rectal tenesmus in cancer","volume":"31","author":"\u00c1 N\u00ed Laoire","year":"2017","journal-title":"Palliat Med"},{"issue":"02","key":"ref25","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1001\/jamasurgery.2013.413","article-title":"Anastomotic leak after low anterior resection: a spectrum of clinical entities","volume":"148","author":"H Caulfield","year":"2013","journal-title":"JAMA Surg"},{"issue":"05","key":"ref26","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1097\/SLA.0000000000002429","article-title":"Anastomotic leakage and chronic presacral sinus formation after low anterior resection: results from a large cross-sectional study","volume":"266","author":"W AA Borstlap","year":"2017","journal-title":"Ann Surg"},{"issue":"06","key":"ref27","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1055\/s-0041-1732322","article-title":"Diagnosis and management of chronic anastomotic leak","volume":"34","author":"A R Bhama","year":"2021","journal-title":"Clin Colon Rectal Surg"},{"issue":"04","key":"ref28","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1111\/codi.16863","article-title":"Management of acute and chronic pelvic sepsis after total mesorectal excision for rectal cancer-a 10-year experience of a national referral centre","volume":"26","author":"S Sharabiany","year":"2024","journal-title":"Colorectal Dis"},{"issue":"05","key":"ref29","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.amjsurg.2010.04.022","article-title":"Management of colorectal anastomotic leakage: differences between salvage and anastomotic takedown","volume":"204","author":"D Fraccalvieri","year":"2012","journal-title":"Am J Surg"},{"issue":"06","key":"ref30","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.dld.2015.02.007","article-title":"Endo-sponge therapy for management of anastomotic leakages after colorectal surgery: A case series and review of literature","volume":"47","author":"G Strangio","year":"2015","journal-title":"Dig Liver Dis"},{"issue":"07","key":"ref31","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1007\/s10151-020-02200-1","article-title":"The use of Endo-SPONGE\u00ae in rectal anastomotic leaks: a systematic review","volume":"24","author":"B Mahendran","year":"2020","journal-title":"Tech Coloproctol"},{"issue":"08","key":"ref32","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.1007\/s00464-007-9706-x","article-title":"Endoscopic vacuum-assisted closure of anastomotic leakage following anterior resection of the rectum: a new method","volume":"22","author":"R Weidenhagen","year":"2008","journal-title":"Surg Endosc"},{"issue":"01","key":"ref33","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/s00384-017-2923-4","article-title":"A novel endoscopic treatment for anastomotic leakage post anterior resection: Padlock over the scope clip","volume":"33","author":"C Robertson","year":"2018","journal-title":"Int J Colorectal Dis"},{"issue":"11","key":"ref34","doi-asserted-by":"crossref","first-page":"3330","DOI":"10.1007\/s00464-012-2340-2","article-title":"Efficacy of the over-the-scope clip (OTSC) for treatment of colorectal postsurgical leaks and fistulas","volume":"26","author":"A Arezzo","year":"2012","journal-title":"Surg Endosc"},{"issue":"03","key":"ref35","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s10151-010-0600-5","article-title":"Use of the endostapler for the treatment of non-healing sinus secondary to a dehisced colorectal anastomosis","volume":"14","author":"N Alsanea","year":"2010","journal-title":"Tech Coloproctol"},{"issue":"09","key":"ref36","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1097\/j.pain.0000000000000237","article-title":"Chronic pain in the pelvic area or lower extremities after rectal cancer treatment and its impact on quality of life: a population-based cross-sectional study","volume":"156","author":"M L Feddern","year":"2015","journal-title":"Pain"},{"issue":"03","key":"ref37","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1055\/s-0038-1677027","article-title":"Overlooked long-term complications of colorectal surgery","volume":"32","author":"M D Giglia","year":"2019","journal-title":"Clin Colon Rectal Surg"},{"issue":"02","key":"ref38","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1111\/codi.15517","article-title":"Management guidelines for low anterior resection syndrome - the MANUEL project","volume":"23","author":"P Christensen","year":"2021","journal-title":"Colorectal Dis"},{"issue":"40","key":"ref39","doi-asserted-by":"crossref","first-page":"4447","DOI":"10.3748\/wjg.v17.i40.4447","article-title":"Chronic proctalgia and chronic pelvic pain syndromes: new etiologic insights and treatment options","volume":"17","author":"G Chiarioni","year":"2011","journal-title":"World J Gastroenterol"},{"issue":"02","key":"ref40","doi-asserted-by":"crossref","first-page":"147","DOI":"10.36076\/ppj.2018.2.147","article-title":"Anatomy, pathophysiology and interventional therapies for chronic pelvic pain: a review","volume":"21","author":"C W Hunter","year":"2018","journal-title":"Pain Physician"},{"issue":"14","key":"ref41","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1001\/jama.2020.14205","article-title":"Association of receipt of palliative care interventions with health care use, quality of life, and symptom burden among adults with chronic noncancer illness: a systematic review and meta-analysis","volume":"324","author":"K L Quinn","year":"2020","journal-title":"JAMA"},{"issue":"01","key":"ref42","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1200\/JCO.2016.70.1474","article-title":"Integration of palliative care into standard oncology care: American Society of Clinical Oncology Clinical Practice Guideline update","volume":"35","author":"B R Ferrell","year":"2017","journal-title":"J Clin Oncol"},{"issue":"12","key":"ref43","doi-asserted-by":"crossref","first-page":"2637","DOI":"10.1200\/JCO.2005.12.107","article-title":"Late referrals to specialized palliative care service in Japan","volume":"23","author":"T Morita","year":"2005","journal-title":"J Clin Oncol"},{"issue":"01","key":"ref44","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1186\/s12904-022-01114-z","article-title":"Palliative care outpatients in a German comprehensive cancer center-identifying indicators for early and late referral","volume":"21","author":"S M\u00fcller","year":"2022","journal-title":"BMC Palliat Care"},{"issue":"08","key":"ref45","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1056\/NEJMoa1000678","article-title":"Early palliative care for patients with metastatic non-small-cell lung cancer","volume":"363","author":"J S Temel","year":"2010","journal-title":"N Engl J Med"},{"issue":"02","key":"ref46","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1001\/jamasurg.2019.5083","article-title":"Palliative care and end-of-life outcomes following high-risk surgery","volume":"155","author":"M Yefimova","year":"2020","journal-title":"JAMA Surg"},{"issue":"20","key":"ref47","doi-asserted-by":"crossref","first-page":"2104","DOI":"10.1001\/jama.2016.16840","article-title":"Association between palliative care and patient and caregiver outcomes: a systematic review and meta-analysis","volume":"316","author":"D Kavalieratos","year":"2016","journal-title":"JAMA"},{"issue":"07","key":"ref48","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1001\/jama.2009.1198","article-title":"Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the Project ENABLE II randomized controlled trial","volume":"302","author":"M Bakitas","year":"2009","journal-title":"JAMA"},{"issue":"9930","key":"ref49","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1016\/S0140-6736(13)62416-2","article-title":"Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial","volume":"383","author":"C Zimmermann","year":"2014","journal-title":"Lancet"},{"issue":"01","key":"ref50","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s11605-018-3929-0","article-title":"Regional differences in palliative care utilization among geriatric colorectal cancer patients needing emergent surgery","volume":"23","author":"D R Heller","year":"2019","journal-title":"J Gastrointest Surg"},{"issue":"09","key":"ref51","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1111\/jgs.13615","article-title":"\u201cBest Case\/Worst Case\u201d: Qualitative evaluation of a novel communication tool for difficult in-the-moment surgical decisions","volume":"63","author":"J M Kruser","year":"2015","journal-title":"J Am Geriatr Soc"},{"issue":"07","key":"ref52","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1001\/jamasurg.2023.1396","article-title":"Effects of specialist palliative care for patients undergoing major abdominal surgery for cancer: a randomized clinical trial","volume":"158","author":"M C Shinall Jr","year":"2023","journal-title":"JAMA Surg"},{"issue":"05","key":"ref53","doi-asserted-by":"crossref","first-page":"e2314660","DOI":"10.1001\/jamanetworkopen.2023.14660","article-title":"Effect of perioperative palliative care on health-related quality of life among patients undergoing surgery for cancer: a randomized clinical trial","volume":"6","author":"R A Aslakson","year":"2023","journal-title":"JAMA Netw Open"}],"container-title":["Clinics in Colon and Rectal Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0045-1807756.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T23:32:41Z","timestamp":1766187161000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0045-1807756"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,21]]},"references-count":52,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2025,12,19]]},"published-print":{"date-parts":[[2026,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0045-1807756","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1531-0043","1530-9681"],"issn-type":[{"type":"print","value":"1531-0043"},{"type":"electronic","value":"1530-9681"}],"subject":[],"published":{"date-parts":[[2025,4,21]]}}}