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Endoscopic ischemic polypectomy for small-bowel polyps in patients with Peutz-Jeghers syndrome

Tsevelnorov Khurelbaatar1,2, Hirotsugu Sakamoto1, Tomonori Yano1

  • 1Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi, Japan.

Endoscopy
|October 1, 2020
PubMed

Insights

Ischemic polypectomy using double-balloon endoscopy (DBE) is effective for managing small-bowel polyps in Peutz-Jeghers syndrome patients. This technique helps control polyp growth, reducing the need for invasive surgery.

Area of Science:

  • Gastroenterology
  • Endoscopy
  • Genetics

Background:

  • Peutz-Jeghers syndrome is associated with numerous small-bowel polyps, increasing risks of bleeding and perforation.
  • Ischemic polypectomy using double-balloon endoscopy (DBE) is a technique employed to mitigate these risks.

Purpose of the Study:

  • To evaluate the effectiveness and feasibility of ischemic polypectomy for managing small-bowel polyps in patients with Peutz-Jeghers syndrome.

Main Methods:

  • Retrospective review of patients undergoing ischemic polypectomy with DBE between July 2004 and August 2017.
  • Analysis of polyp burden and procedural outcomes over multiple DBE sessions.

Main Results:

  • 67 therapeutic DBEs were performed on nine patients, treating 352 polyps.
  • A declining trend in the number of large polyps (>15mm) treated per session was observed over time.
  • No patient required laparotomy; one experienced mild pancreatitis.

Conclusions:

  • Ischemic polypectomy is a feasible and effective endoscopic treatment for controlling small-bowel polyps in Peutz-Jeghers syndrome.
  • The procedure demonstrates a potential for long-term management of polyps in affected individuals.
Abstract

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