Total parenteral nutrition (TPN) with complete nutritive mixtures: An artificial gut in cancer patients

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Abstract
A new technique in total parenteral nutrition (TPN), involving a deep vein indwelling catheter as a vascular access route, was applied to cancer patients in order to obtain a positive nitrogen balance. Various complete nutritive mixtures were administered; all were aseptic and apyrogenic; normonutrition mixtures contained 2000, 25000 and 3000 ml of solvent, while hyper‐nutrition mixtures contained 600 and 1200 ml of solvent. TPN (average duration 1.4 months) was used in 2122 cancer patients: 74.6% of patients underwent surgery, 15.8% had radiotherapy and 9.6% received only chemotherapy. A significant increase in the rate of operability of tumors was noted as a result of preoperative TPN, as well as an increase in the number of procedures involving extensive visceral resection. The results of a randomized study involving 81 patients with pelvic and/or abdominal irradiation revealed a significant increase in the degree to which radiotherapy was tolerated by the patients when TPN was administered during the same period. In addition, numerous patients had a neutral or slightly positive nitrogen balance throughout the week during which they were given chemo‐therapeutic agents. The results of tests involving these patients showed a correlation between the prognosis of the disease and the immune response of the patient, with a notable rise in T‐lymphocyte function in association with long‐term TPN.