Belsha Dalia, Urs Arun, Attard Thomas, Thomson Mike
*Sheffield Children's Hospital, Western Bank, Sheffield, United Kingdom †Children's Mercy Hospital, Kansas City, MO.
J Pediatr Gastroenterol Nutr. 2017 Nov;65(5):500-502. doi: 10.1097/MPG.0000000000001576.
Sizable small-bowel (SB) polyps in Peutz-Jeghers syndrome (PJS) pose a high risk for intussusception, often necessitating laparotomy and intraoperative enteroscopy. This series examines the effectiveness of double-balloon enteroscopy (DBE) facilitated polypectomy for pediatric patients with PJS. Prospective analysis of collected data (6 years) on all patients with PJS referred for DBE-facilitated SB polypectomy at a pediatric tertiary-referral center. A total of 16 pediatric patients with PJS were referred for DBE-facilitated SB polypectomy. Twenty-two DBEs were performed. Large polyps (≥1 cm) were confirmed in 14 patients. Successful clearance of large SB polyps by DBE or laparoscopically assisted DBE (Lap-DBE) was achieved in all patients. One patient experienced post-Lap-DBE pelvic abscess. All other patients remained asymptomatic and intervention free throughout follow-up (median 26 months). This series demonstrates that DBE-facilitated polypectomy is an effective therapeutic option in pediatric patients with PJS. It should be considered at an early age where possible.
黑斑息肉综合征（PJS）中的小肠（SB）大息肉会导致肠套叠的高风险，通常需要进行剖腹手术和术中肠镜检查。本系列研究探讨了双气囊小肠镜（DBE）辅助息肉切除术对PJS患儿的有效性。对一家儿科三级转诊中心所有因DBE辅助SB息肉切除术而转诊的PJS患者的收集数据（6年）进行前瞻性分析。共有16例PJS患儿因DBE辅助SB息肉切除术而转诊。共进行了22次DBE检查。14例患者确诊为大息肉（≥1 cm）。所有患者均通过DBE或腹腔镜辅助DBE（Lap-DBE）成功清除了大的SB息肉。1例患者在Lap-DBE术后出现盆腔脓肿。所有其他患者在整个随访期间（中位时间26个月）均无症状且无需干预。本系列研究表明，DBE辅助息肉切除术是PJS患儿的一种有效治疗选择。应尽可能在早期考虑。
