Nutrición al final de la vida: Perspectiva paliativa del cirujano

Abstract

Introduction: The care of cancer patients at the end-of-life represents a clinical challenge and an ethical and moral dilemma. Establishing follow-up strategies for the patient and his or her family, or the nutritional strategies to undertake is not easy. The objective of this review is to analyze theoretical aspects defined in the literature on the definition of end-of-life and the nutritional management strategies for cancer patients obtained from the experience of the Hepatobiliary and Pancreatic Surgery Service at Méderi Hospital in Bogotá, Colombia.

Methods: A literature search was carried out using the terms: “nutrition”, “palliative care”, “nutrition in cancer”, “end-of-life”. The different end-of-life nutritional strategies for patients with hepatobiliary and pancreatic terminal disease are described.

Results: Clinical deterioration of patients in this stage of life is irreversible, and the protein and energy intake delivered through a parenteral or enteral access, do not change the patient’s prognosis. The ultimate goal of nutritional therapy in the patient at the end-of-life is maintaining quality of life. Proper communication with the patient and his or her family is essential to reduce anxiety and facilitate decision-making.

Conclusion: Nutritional management in cancer patients at the end-of-life is a huge medical challenge. The experience of the Hepatobiliary and Pancreatic Surgery Service provides a human and palliative perspective focused on accompanying the patient and his or her family, thus recovering the fundamental concept of the doctor-patient relationship