ABSTRACT
SUMMARY In the emergency care of cancer patients, in addition to cancer-related factors, two aspects influence the outcome: (1) where the patient is treated and (2) who will perform the surgery. In Brazil, a significant proportion of patients with surgical oncological emergencies will be operated on in general hospitals by surgeons without training in oncological surgery. OBJECTIVE: The objective was to discuss quality indicators and propose the creation of an urgent oncological surgery advanced life support course. METHODS: Review of articles on the topic. RESULTS: Generally, nonelective resections are associated with higher rates of morbidity and mortality, as well as lower rates of cancer-specific survival. In comparison to elective procedures, the reduced number of harvested lymph nodes and the higher rate of positive margins suggest a compromised degree of radicality in the emergency scenario. CONCLUSION: Among modifiable factors is the training of the emergency surgeon. Enhancing the practice of oncological surgery in emergency settings constitutes a formidable undertaking that entails collaboration across various medical specialties and warrants endorsement and support from medical societies and educational institutions. It is time to establish a national registry encompassing oncological emergencies, develop quality indicators tailored to the national context, and foster the establishment of specialized training programs aimed at enhancing the proficiency of physicians serving in emergency services catering to cancer patients.
ABSTRACT
Objetivo Se realiza una aproximación a las barreras geográficas y económicas para el acceso a los servicios oncológicos del Instituto Nacional de Cancerología-INC; Se presenta la necesidad de plantear alternativas para afrontar estas problemáticas y considerar estudios que evalúen problemáticas similares y sus soluciones Métodos Se utilizaron los métodos cualitativo y cuantitativo en lo referente a datos estadísticos, dentro de un contexto de interés social, con un enfoque empírico analítico. Resultados Se encontró que durante el 2005, tuvieron acceso al programa de albergues solo 176 pacientes de los 3 391 pacientes provenientes de regiones del país distintas a Bogotá atendidos en el mismo periodo; es decir que el programa solo cubrió el 5,19 por ciento de los pacientes de diferentes lugares del país. De igual manera se encontró que se debe afrontar la inequidad de género que hasta la fecha se ha venido presentando con los varones. Conclusiones Se deben buscar alternativas de alojamiento diferentes a los albergues, que hagan posible el acceso al tratamiento especializado con dignidad y calidad de vida. El estudio permitió plantear alternativas de solución a corto, mediano y largo plazo.
Objective Geographical and economic barriers to access to National Cancer Institute (NCI) oncology services were evaluated; such approach revealed the need for alternatives for dealing with these issues and considering studies aimed at assessing similar problems and resolving them. Methods An analytical empirical approach used qualitative and quantitative statistical methods were used within a context of social concern. Results Only 176 out of 3 391 patients had access to the "Temporary-housing programme" during 2005, covering 5,19 percent of all patients coming from remote regions of Colombia. Most patients were women who were looking for alternatives outside the institutional programmes being offered. Conclusion There is a need to fix gender inequity and search for better housing alternatives to providing refuges, providing access to specialised treatment and the need for attending people with dignity and ensuring quality of life. The study led to proposing new short-, medium- and long-term alternatives for improving health service access.