Endoscopic therapy of small-bowel polyps by double-balloon enteroscopy in patients with Peutz-Jeghers syndrome.
BACKGROUND
Peutz-Jeghers syndrome (PJS) is a hereditary disorder characterized by mucocutaneous pigmentations and hamartomatous polyps mainly in the small bowel. These polyps may cause complications such as intussusception.


OBJECTIVE
To assess therapeutic efficacy and safety of double-balloon enteroscopy (DBE) for detection and treatment of small-bowel polyps in patients with PJS.


METHODS
Prospective cohort study.


METHODS
Tertiary-care referral center.


METHODS
This study involved 13 patients with PJS, defined as a proven STK11 gene mutation or according to international diagnostic criteria.


METHODS
DBE with enteroscopic removal of pedunculated polyps of > or =10 mm.


METHODS
Location, number and size of small-bowel polyps, polypectomy data, and complications and long-term complications associated with development of small-intestine polyps.


RESULTS
Thirteen patients with PJS (8 male, mean age 31 years) underwent 29 DBE procedures. Ten patients (77%) had a history of partial small-bowel resection because of small-bowel polyps. Small-bowel polyps were found in all 13 patients. The majority of polyps (94%) were located in the proximal jejunum. A total of 82 polyps of > or =10 mm were detected, and 79 (96%) were endoscopically removed without complications. After the introduction of DBE, no small-intestine-polyp-related complications occurred during a follow-up period of 356 person-months.


CONCLUSIONS
Small number of patients.


CONCLUSIONS
DBE is clinically useful and safe for diagnosis and therapy of small-bowel polyps in patients with PJS, even in patients with a history of extensive abdominal surgery. DBE may decrease the need for laparotomy in patients with PJS.
Gao
Hong
H
Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
van Lier
Margot G
MG
Poley
Jan Werner
JW
Kuipers
Ernst J
EJ
van Leerdam
Monique E
ME
Mensink
Peter B
PB
D000091162:AMP-Activated Protein Kinase Kinases; D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D020776:Endoscopes, Gastrointestinal; D005260:Female; D005838:Genotype; D006801:Humans; D007078:Ileal Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000601:surgery*; D007580:Jejunal Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000601:surgery*; D008297:Male; D009154:Mutation; D010580:Peutz-Jeghers Syndrome / Q000175:diagnosis / Q000235:genetics / Q000601:surgery*; D011446:Prospective Studies; D017346:Protein Serine-Threonine Kinases / Q000235:genetics; D016896:Treatment Outcome; D055815:Young Adult
D017346:Protein Serine-Threonine Kinases; C109790:STK11 protein, human; D000091162:AMP-Activated Protein Kinase Kinases