Towards decreasing the relaparotomy rate in the Peutz-Jeghers syndrome: the role of peroperative small bowel endoscopy.
Relaparotomy occurs commonly in patients with the Peutz-Jeghers syndrome, and at quite short intervals. Between 1943 and 1987 laparotomies were performed on 54 occasions in 23 patients with the Peutz-Jeghers syndrome who at some time came under the care of St. Mark's Hospital. In four patients repeat laparotomy was performed within a single year. Between 1987 and 1989 a further five patients have undergone laparotomy with on-table small bowel endoscopy. External palpation and small bowel transillumination failed to demonstrate 17 out of a total of 45 hamartomas (38 per cent). Of these 17 polyps identified endoscopically, 11 (65 per cent) were sufficiently large that a snare was used to remove them. We recommend peroperative enteroscopy as an adjunct to surgery in the Peutz-Jeghers syndrome.
Spigelman
A D
AD
St. Mark's Hospital, London, UK.
Thomson
J P
JP
Phillips
R K
RK
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy; D005260:Female; D006801:Humans; D007417:Intestinal Polyps / Q000175:diagnosis / Q000601:surgery; D007421:Intestine, Small / Q000601:surgery; D007430:Intraoperative Care; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D010580:Peutz-Jeghers Syndrome / Q000601:surgery*; D011446:Prospective Studies; D012086:Reoperation; D013997:Time Factors