Subscribe to RSS
DOI: 10.1055/a-1276-6452
Endoscopic ischemic polypectomy for small-bowel polyps in patients with Peutz–Jeghers syndrome
![](https://www.thieme-connect.de/media/endoscopy/202107/lookinside/thumbnails/19477_10-1055-a-1276-6452-1.jpg)
Abstract
Background To decrease the risk of bleeding or perforation, ischemic polypectomy is performed using a detachable snare or endoclip with double-balloon endoscopy (DBE) for small-bowel polyps in patients with Peutz – Jeghers syndrome. The aim of this study was to determine the effectiveness and feasibility of ischemic polypectomy.
Methods We retrospectively reviewed patients who underwent two or more sessions of ischemic polypectomy using DBE from July 2004 to August 2017.
Results 67 therapeutic DBEs were performed in nine patients during the study period and 352 polyps were treated. The median observation period was 34 months (range 12 – 66). There was a declining trend over time in the median number of polyps > 15 mm treated per patient first DBE session 6, second 2, third 1.5, fourth 0.5, fifth 0.5; P = 0.11, Friedman test). No patient required laparotomy due to intussusception during the study period. One patient developed mild acute pancreatitis after the procedure.
Conclusions Ischemic polypectomy was feasible for the control of small-bowel polyps in patients with Peutz – Jeghers syndrome.
Publication History
Received: 09 September 2020
Accepted: 01 October 2020
Accepted Manuscript online:
01 October 2020
Article published online:
16 December 2020
© 2020. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Jeghers H, Mc KV, Katz KH. Generalized intestinal polyposis and melanin spots of the oral mucosa, lips and digits; a syndrome of diagnostic significance. N Engl J Med 1949; 241: 1031-1036
- 2 Beggs AD, Latchford AR, Vasen HF. et al. Peutz–Jeghers syndrome: a systematic review and recommendations for management. Gut 2010; 59: 975-986
- 3 Hinds R, Philp C, Hyer W. et al. Complications of childhood Peutz–Jeghers syndrome: implications for pediatric screening. J Pediatr Gastroenterol Nutr 2004; 39: 219-220
- 4 Yamamoto H. Fifteen years since the advent of double-balloon endoscopy. Clin Gastroenterol Hepatol 2017; 15: 1647-1650
- 5 Sakamoto H, Yamamoto H, Hayashi Y. et al. Nonsurgical management of small-bowel polyps in Peutz–Jeghers syndrome with extensive polypectomy by using double-balloon endoscopy. Gastrointest Endosc 2011; 74: 328-333
- 6 Serrano M, Mao-de-Ferro S, Pinho R. et al. Double-balloon enteroscopy in the management of patients with Peutz–Jeghers syndrome: a retrospective cohort multicenter study. Rev Esp Enferm Dig 2013; 105: 594-599
- 7 Wang YX, Bian J, Zhu HY. et al. The role of double-balloon enteroscopy in reducing the maximum size of polyps in patients with Peutz–Jeghers syndrome: 12-year experience. J Dig Dis 2019; 20: 415-420
- 8 Yano T, Shinozaki S, Yamamoto H. Crossed-clip strangulation for the management of small intestinal polyps in patients with Peutz–Jeghers syndrome. Dig Endosc 2018; 30: 677
- 9 Takakura K, Kato T, Arihiro S. et al. Selective ligation using a detachable snare for small-intestinal polyps in patients with Peutz–Jeghers syndrome. Endoscopy 2011; 43 (Suppl. 02) E264-265
- 10 Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 2013; 48: 452-458
- 11 Shinozaki S, Kobayashi Y, Hayashi Y. et al. Efficacy and safety of cold versus hot snare polypectomy for resecting small colorectal polyps: systematic review and meta-analysis. Dig Endosc 2018; 30: 592-599
- 12 Gao H, van Lier MG, Poley JW. et al. Endoscopic therapy of small-bowel polyps by double-balloon enteroscopy in patients with Peutz–Jeghers syndrome. Gastrointest endosc 2010; 71: 768-773
- 13 Zepeda-Gomez S, Barreto-Zuniga R, Ponce-de-Leon S. et al. Risk of hyperamylasemia and acute pancreatitis after double-balloon enteroscopy: a prospective study. Endoscopy 2011; 43: 766-770