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


METHODS
Retrospective review.


METHODS
Single, North American tertiary-care center.


METHODS
Individuals with PJS and small-bowel polyps identified by other modalities.


METHODS
DBE was combined with laparoscopy as a single-procedure surveillance and therapeutic strategy for small-bowel PJS polyps.


METHODS
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.


CONCLUSIONS
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.
Ross
Andrew S
AS
Current affiliations: Section of Endoscopy and Therapeutics and Section of General Surgery, The University of Chicago Hospitals, Chicago, Illinois, USA.
Dye
Charles
C
Prachand
Vivek N
VN
D000328:Adult; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010580:Peutz-Jeghers Syndrome / Q000175:diagnosis / Q000601:surgery*