Management of small-bowel polyps in Peutz-Jeghers syndrome by using enteroclysis, double-balloon enteroscopy, and videocapsule endoscopy.
BACKGROUND
Management of small-bowel polyps in Peutz-Jeghers syndrome (PJS) by using fluoroscopic enteroclysis (FE), double-balloon enteroscopy (DBE), and videocapsule enteroscopy (VCE) remains incompletely determined.


OBJECTIVE
To evaluate the usefulness of FE, VCE, and DBE and compute the polyp growth rate.


METHODS
Single-center retrospective study.


METHODS
Tertiary referral hospital.


METHODS
Between June 2003 and January 2010, 18 consecutive patients with PJS were enrolled.


METHODS
Polyp detection rates among FE, VCE, and DBE, histology of resected polyps, and the polyp growth rate.


RESULTS
Total enteroscopy rate was higher at VCE (89%) than at DBE (52%; 27% in patients with ≥2 previous laparotomies and 90% in patients with ≤1 [P = .001]). FE demonstrated fewer polyps than DBE, whereas VCE had detection rates similar to those of DBE. Of 387 DBE-resected and 22 surgically resected polyps, histologic analysis of 110 retrieved polyps showed adenoma or adenocarcinoma in 30.0% of polyps >20 mm and in only 1.3% of polyps ≤20 mm (P < .0001). Multiple linear regression analysis showed that the number of small-bowel polyps >10 mm (X1; P = .0366) and colorectal polyps >5 mm (X2; P = .002) were independent predictors of the growth rate of small-bowel polyps (Y), and a forward stepwise selection model was constructed: Y = 0.136 × X1 + 0.289 × X2 - 0.589 (R(2) = 0.665).


CONCLUSIONS
Small sample size.


CONCLUSIONS
DBE and VCE were useful for the management of small-bowel polyps in PJS. VCE may replace barium examinations for surveillance after polyp resection at intervals depending on the polyp growth rate.
Ohmiya
Naoki
N
Department of Gastroenterology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
Nakamura
Masanao
M
Takenaka
Hiroyuki
H
Morishima
Kenji
K
Yamamura
Takeshi
T
Ishihara
Makoto
M
Miyahara
Ryoji
R
Kawashima
Hiroki
H
Itoh
Akihiro
A
Hirooka
Yoshiki
Y
Watanabe
Osamu
O
Ando
Takafumi
T
Goto
Hidemi
H
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000236:Adenoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D053704:Capsule Endoscopy; D002648:Child; D002675:Child, Preschool; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003287:Contrast Media / Q000008:administration & dosage; D058582:Double-Balloon Enteroscopy; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007580:Jejunal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D007583:Jejunum / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010580:Peutz-Jeghers Syndrome / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012680:Sensitivity and Specificity; D055815:Young Adult
D003287:Contrast Media