Oguro Kunihiko, Sakamoto Hirotsugu, Yano Tomonori, Funayama Yohei, Kitamura Masafumi, Nagayama Manabu, Sunada Keijiro, Lefor Alan Kawarai, Yamamoto Hironori
Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi, Japan.
Department of Surgery, Jichi Medical University, Tochigi, Japan.
Endosc Int Open. 2022 Dec 15;10(12):E1583-E1588. doi: 10.1055/a-1954-0110. eCollection 2022 Dec.
Intussusception caused by intestinal polyps in patients with Peutz-Jeghers syndrome usually requires laparotomy. Patients following successful endoscopic reduction using double-balloon endoscopy (DBE) have been reported. The aim of this study was to evaluate the feasibility of endoscopic treatment of intussusception. We retrospectively reviewed patients who underwent DBE for intussusception due to small intestine polyps in patients with Peutz-Jeghers syndrome from January 2004 to June 2020. Twenty-seven (antegrade 22, retrograde 5) DBEs were performed in 19 patients with 25 sites of intussusception identified during the study period. If the intussusception remained once the endoscope reached the site, endoscopic reduction of the intussusception was performed as needed (15 sites). Ultimately, endoscopic resections (8 sites) or ischemic polypectomies (16 sites) of the polyp causing the intussusception were completed at 24 sites. Only one site could not be treated endoscopically and was treated surgically. The final per-site and per-patient success rates of endoscopic treatment were 96 % (24/25) and 95 % (18/19) respectively. Two patients developed mild acute pancreatitis and one patient developed intussusception after the procedures, both of which were treated non-operatively. Endoscopic treatment of intussusception is feasible to avoid laparotomy in patients with Peutz-Jeghers syndrome.
黑斑息肉综合征患者因肠道息肉引起的肠套叠通常需要开腹手术。有报道称，患者可通过双气囊小肠镜（DBE）成功进行内镜复位。本研究的目的是评估内镜治疗肠套叠的可行性。我们回顾性分析了2004年1月至2020年6月期间因黑斑息肉综合征患者小肠息肉导致肠套叠而接受DBE治疗的患者。在研究期间，对19例患者进行了27次（顺行22次，逆行5次）DBE，共发现25处肠套叠。如果内镜到达套叠部位后套叠仍存在，则根据需要进行内镜下肠套叠复位（15处）。最终，在24处完成了导致肠套叠的息肉的内镜切除（8处）或缺血性息肉切除术（16处）。只有一处无法通过内镜治疗，需进行手术治疗。内镜治疗的最终每处及每位患者的成功率分别为96%（24/25）和95%（18/19）。两名患者术后发生轻度急性胰腺炎，一名患者术后发生肠套叠，均采用非手术治疗。对于黑斑息肉综合征患者，内镜治疗肠套叠可避免开腹手术，是可行的。
