Blanco-Velasco G, Hernández-Mondragón O V, Blancas-Valencia J M, Paz-Flores V, Fuentes-Hernández D, Rodríguez-González P, González-Ortíz B
Servicio de Endoscopia, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
Servicio de Endoscopia, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
Rev Gastroenterol Mex (Engl Ed). 2018 Jul-Sep;83(3):234-237. doi: 10.1016/j.rgmx.2017.07.003. Epub 2018 Feb 12.
Peutz-Jeghers syndrome is an autosomal dominant inherited pathology characterized by gastrointestinal hamartomatous polyps, predominantly in the small bowel, and pigmented mucocutaneous lesions. Guidelines suggest polypectomy with a balloon-assisted enteroscope when polyps are larger than 10mm. Complications in adults can be as high as 6.8%, but there is little information on pediatric populations. Our aim was to describe the safety and efficacy of polypectomy in a group of pediatric patients with Peutz-Jeghers syndrome using balloon-assisted enteroscopy.
A retrospective study was conducted at the Hospital de Especialidades del Centro Médico Nacional Siglo XXI on pediatric patients with Peutz-Jeghers syndrome that required balloon-assisted enteroscopy and polypectomy within the time frame of January 2010 and December 2015. Patients that underwent polypectomy with a push enteroscope were excluded from the study.
A total of 35 polypectomies were performed on 4 patients (female/male: 3/1). The mean age of the patients was 13.7 years (range:11-16). Twelve enteroscopies were carried out, 8 of which were anterograde. A single-balloon enteroscope was used in 7 procedures and a double-balloon enteroscope in 5. The mean size of the polyps was 1.6cm (range: 1-4cm). A major complication (acute pancreatitis) presented in only one case (8.3%). No other major complications associated with the procedures were observed.
Balloon-assisted enteroscopy with polypectomy in children is a safe and effective procedure, with complications similar to those reported in adults.
黑斑息肉综合征是一种常染色体显性遗传性疾病，其特征为胃肠道错构瘤性息肉（主要位于小肠）和色素沉着性黏膜皮肤病变。指南建议，当息肉大于10毫米时，使用气囊辅助小肠镜进行息肉切除术。成人患者的并发症发生率可高达6.8%，但关于儿科人群的相关信息较少。我们的目的是描述使用气囊辅助小肠镜对一组患有黑斑息肉综合征的儿科患者进行息肉切除术的安全性和有效性。
在墨西哥国立医学中心二十一世纪专科医院对2010年1月至2015年12月期间需要气囊辅助小肠镜检查和息肉切除术的黑斑息肉综合征儿科患者进行了一项回顾性研究。接受推进式小肠镜息肉切除术的患者被排除在研究之外。
共对4例患者（女/男：3/1）进行了35次息肉切除术。患者的平均年龄为13.7岁（范围：11 - 16岁）。进行了12次小肠镜检查，其中8次为顺行性检查。7例手术使用了单气囊小肠镜，5例使用了双气囊小肠镜。息肉的平均大小为1.6厘米（范围：1 - 4厘米）。仅1例（8.3%）出现严重并发症（急性胰腺炎）。未观察到与手术相关的其他严重并发症。
儿童气囊辅助小肠镜息肉切除术是一种安全有效的手术，并发症与成人报道的相似。
