[Experience and problems with home parenteral nutrition for patients with peritonitis carcinomatosa]

Since 1987, we have been using home parenteral nutrition (HPN) for patients with peritonitis carcinomatosa, who had undergone surgery for cancer of the digestive tract and who could not take food orally. We have been inserted catheterization for HPN in 90 patients. Nine of them underwent the treatment as training, but HPN was possible in the remaining 81 patients (90%). The patients in whom the treatment failed to be transferred to HPN showed worsening of their general condition during hospitalization, because the period of training was long. As a result, they could not be discharge. We considered that the timing of transfer to HPN was inappropriate. The largest number of patients, 57, had undergone surgery for cancer of the stomach and esophagus, which was the underlying disease. The mean period of HPN was 108.2 days. According to the underlying disease, the period was longest, 115.7 days, for cancer of the stomach and esophagus, followed by 93.8 days for colorectal cancer. The performed rate of HPN for 60, 90, 180 and 270 days were 56.7, 36.0, 17.9 and 6.5%, respectively, with the one-year cumulative rate of 3.3%. HPN for terminal stage of cancer is an effective treatment for patients with peritonitis carcinomatosa, and it allowed improvement in the quality of life. Cooperation with various medical staff members is also necessary and a hospital system should be established for safe and smooth achievement of the treatment method.