Laparoscopic-assisted double-balloon enteroscopy for small-bowel polyp surveillance and treatment in patients with Peutz-Jeghers syndrome.

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.

journal_name

Gastrointest Endosc

authors

Ross AS,Dye C,Prachand VN

doi

10.1016/j.gie.2006.05.031

subject

Has Abstract

pub_date

2006-12-01 00:00:00

pages

984-8

issue

6

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(06)02088-8

journal_volume

64

pub_type

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