THE ROLE OF TOTAL PARENTERAL-NUTRITION FOR PATIENTS WITH IRREVERSIBLEBOWEL OBSTRUCTION SECONDARY TO GYNECOLOGICAL MALIGNANCY

Two patients received total parenteral nutrition (TPN) to manage irrev ersible bowel obstruction secondary to gynecological malignancy. The u se of TPN prolonged their lives considerably, but also led to complica tions, both from the TPN and from the natural progression of the cance rs. Although TPN is increasingly considered as a possible treatment fo r selected patients with malignant bowel obstruction who are not suita ble for surgery, the literature regarding this practice is conflicting . It should be considered only in those patients with good performance status, and then after careful attention to not only the likely medic al and symptomatic outcomes, but also the ethical implications of such a management strategy. (C) U.S. Cancer Pain Relief Committee, 1997.