[Progress in postoperative care and postoperative combined therapy of esophageal carcinoma by total parenteral nutrition (TPN)].

Intravenous hyperalimentation which consisted of 30% hypertonic glucose solution and 10% amino acid solution via central venous catheterization and 10% lipid solution via peripheral venous lines has been applied to the postoperative patients with esophageal cancers since 10 years ago. sixty-five percent of the patients who underwent surgical treatment showed abnormal signs of the glucose tolerance function test. Positive application of insulin for these patients was performed according to the algorism of continuous insulin infusion method devised by us. Serum glucose levels have been kept within the normal range during the postoperative days. Non-protein Calorie per nitrogen (Cal/N) was optimal at 190, and 10% of the total Calorie administered should be obtained as lipid solution. Postoperative changes of glucose synthase I and D, and phosphorylase a and b of leukocytes were analysed periodically. Chemiluminescence of leukocytes were also checked. Postoperative combined therapies were actively performed under the nutritional support of TPN. The cases of n (-), n1(+) and n2(+) were treated with radio-chemoimmunotherapy (4000 R, Bleomycin 80 mg, Tegaful 500-750 mg/day, PSK or OK-432). The cases of n3(+) and n4(+) were treated with aggressive chemotherapy (Adriamycin, Mitomycin and Pepleomycin). Remarkable improvement of the prognosis in these patients was obtained.