Palliation of advanced gastrointestinal malignancies using minimally invasive strategies

Most surgeons are routinely involved in the management of patients with advanced malignancy. While the aim of surgical intervention is often cure, palliation of symptoms and improving patient's quality of life are equally important goals. Effective palliation requires recognition on the surgeon's part of the physical, psychological, social, and spiritual needs of the patient. In addition, effective palliation requires that the surgeon is aware of the latest minimally invasive techniques to treat patients with advance gastrointestinal malignancies.With the application of these minimal invasive techniques, the surgeon can better achieve the goal of surgical palliation-relief of symptoms and improved quality of life with minimization of the surgical burden. Recently, minimally invasive strategies, including laparoscopy, endoscopy, as well as catheter-based interventional radiology techniques have allowed for effective palliation while reducing risks associated with more extensive open surgical procedures. In this review, we highlight three specific gastrointestinal malignancies (i.e. pancreatic, colon, and neuroendocrine cancer) and how the application of minimally invasive techniques has benefitted patients. By highlighting these examples, we emphasize the role of surgery in palliative care, as well as demonstrate how the successful application of minimally invasive techniques has improved the quality of life of patients with advanced gastrointestinal malignancies.