Panos R G, Opelka F G, Nogueras J J
Wilford Hall USAF Medical Center, Lackland Air Force Base, Texas.
Am Surg. 1990 May;56(5):331-3.
Peutz-Jeghers syndrome is a disease manifested by a combination of mucocutaneous pigmentation and gastrointestinal (GI) polyposis. The major morbidity results from intussusception, obstruction, and bleeding. Standard surgical management has been to perform enterotomies at the site of palpable polyps. A method of treating Peutz-Jeghers syndrome surgically with combined intraoperative enteroscopy is presented. The patient had eight large polyps that required three enterotomies for removal. Only three of the polyps were palpable. Two intussusceptions were reduced. The advantages of intraoperative enteroscopy are that 1) it provides accurate assessment of the extent of the disease, 2) smaller polyps can be treated endoscopically, preventing enterotomies, and 3) the endoscopist can direct the surgeon to the appropriate enterotomy sites. A combined surgical and endoscopic approach for the management of Peutz-Jeghers is successful. It more accurately removes the cause of the major morbidity associated with the disease and may allow the patient a longer interval between laparotomies.
黑斑息肉综合征是一种表现为皮肤黏膜色素沉着和胃肠道息肉病的疾病。主要发病原因是肠套叠、肠梗阻和出血。标准的手术治疗方法是在可触及息肉的部位进行肠切开术。本文介绍了一种联合术中肠镜检查手术治疗黑斑息肉综合征的方法。该患者有8个大息肉，需要进行3次肠切开术来切除。只有3个息肉可以触及。复位了2次肠套叠。术中肠镜检查的优点是：1）能准确评估疾病范围；2）较小的息肉可通过内镜治疗，避免肠切开术；3）内镜医生可指导外科医生找到合适的肠切开部位。联合手术和内镜治疗黑斑息肉综合征是成功的。它能更准确地消除与该疾病相关的主要发病原因，可能使患者两次剖腹手术的间隔时间更长。
