Abstract:
:Over a 7 year period, 85 cancer patients were managed by the nutrition service of St. Joseph's Hospital, Toronto. All these patients were nutritionally depleted, had obstruction to the gastrointestinal tract, or had postoperative complications such as enterocutaneous fistulas, evisceration or intraabdominal sepsis, which left total parenteral nutrition (TPN) as the only means of achieving positive nitrogen balance. A prospective study started in 1970 has found that when cancer was resectable and TPN was started preoperatively and continued postoperatively (24 patients-group 1) until the patient could take a normal diet, no deaths or significant complications occurred. When TPN was first started after life-threatening complications had occurred (53 depleted patients-group 2), the mortality was 17.0%. This mortality was only 4.5% after complications following operations for colon cancer, but was much higher with esophageal, pancreatic and bladder cancer, and especially after complications following surgery where radiotherapy had previously been given to abdomen or pelvis. When TPN was used in inoperable, cachectic patients (8 patients-group 3) to permit them to tolerate radiotherapy or chemotherapy, the mortality was 37.5%. This latter group is small, but TPN is worthwhile in selected patients where significant palliation and improvement in the quality of life can occur.
journal_name
Cancerjournal_title
Cancerauthors
Deitel M,Vasic V,Alexander MAdoi
10.1002/1097-0142(197806)41:6<2359::aid-cncr282041subject
Has Abstractpub_date
1978-06-01 00:00:00pages
2359-63issue
6eissn
0008-543Xissn
1097-0142journal_volume
41pub_type
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