Laparoscopic-assisted double-balloon enteroscopy for small-bowel polyp surveillance and treatment in patients with Peutz-Jeghers syndrome - 16/08/11
Reprint requests: Andrew Ross, MD, The University of Chicago Hospitals, 5841 S. Maryland Ave, MC 4076, Chicago, IL 60607.Chicago, Illinois, USA
Abstract |
Background |
Surveillance and treatment of small-bowel polyps in patients with Peutz-Jeghers syndrome (PJS) can be challenging and may require intraoperative enteroscopy. While initial reports that used double-balloon enteroscopy (DBE) for the resection of small-bowel polyps in patients with PJS appear promising, complete enteroscopy when using this technique may require multiple procedures or may not be possible at all.
Objective |
To develop a single-procedure approach to the surveillance and the treatment of small-bowel polyps in patients with PJS.
Design |
Retrospective review.
Setting |
Single, North American tertiary-care center.
Patients |
Individuals with PJS and small-bowel polyps identified by other modalities.
Interventions |
DBE was combined with laparoscopy as a single-procedure surveillance and therapeutic strategy for small-bowel PJS polyps.
Main Outcome Measurements |
Completion of enteroscopy, number of polyps resected, procedure duration, complications.
Results |
Three patients with a history of PJS and known small-bowel polyps underwent laparoscopic-assisted DBE (LADBE). Complete enteroscopy was performed, and all polyps larger than 0.5 cm were resected endoscopically. No cases of cancer or dysplasia were noted; procedure times lasted from 1 to 4 hours. Postoperative complications included ileus in 2 patients.
Limitations |
Small sample size, single-center experience.
Conclusions |
LADBE holds promise as a new technique that can be used as both a surveillance and a therapeutic tool for small-bowel polyps in patients with PJS.
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Vol 64 - N° 6
P. 984-988 - décembre 2006 Retour au numéro
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