Management of small-bowel polyps in Peutz-Jeghers syndrome by using enteroclysis, double-balloon enteroscopy, and videocapsule endoscopy
Management of small-bowel polyps in Peutz-Jeghers syndrome by using enteroclysis, double-balloon enteroscopy, and videocapsule endoscopy
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DOI：
10.1016/j.gie.2010.08.018
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发表时间：
2010-12-01
影响因子：
7.7
通讯作者：
Goto, Hidemi
中科院分区：
文献类型：
--
作者：
Ohmiya, Naoki;Nakamura, Masanao;Goto, Hidemi
背景：使用荧光肠镜检查（FE）、双气囊小肠镜检查（DBE）和视频胶囊小肠镜检查（VCE）治疗黑斑息肉综合征（PJS）的小肠息肉尚未完全确定。目的：评估 FE、VCE 和 DBE 的有用性并计算息肉生长率。设计：单中心回顾性研究。地点：三级转诊医院。患者：6 月间2003 年和 2010 年 1 月，连续纳入 18 名 PJS 患者。主要结果测量：FE、VCE 和 DBE 中的息肉检出率、切除息肉的组织学以及息肉生长率。结果：VCE 时的总肠镜检查率 (89%) 高于 DBE 时的总肠镜检查率 (52%)；既往接受过 2 次剖腹手术的患者为 27%，接受过 20 次剖腹手术的患者为 90%。 mm 且仅 1.3% 的 10 mm 息肉 (X1; P = .0366) 和结直肠息肉 > 5 mm (X2; P = .002) 是小肠息肉生长率 (Y) 的独立预测因子，并构建了向前逐步选择模型：Y = 0.136 X X1 + 0.289 X X2 - 0.589 (R-2 = 0.665）。局限性：样本量小。结论：DBE 和 VCE 对于 PJS 中小肠息肉的治疗很有用，VCE 可以根据息肉生长率定期替代钡检查进行监测（Gastrointest Enclose 2010；72：1209-16）。
Background: Management of small-bowel polyps in Peutz-Jeghers syndrome (PJS) by using fluoroscopic enteroclysis (FE), double-balloon enteroscopy (DBE), and videocapsule enteroscopy (VCE) remains incompletely determined.Objective: To evaluate the usefulness of FE, VCE, and DBE and compute the polyp growth rate.Design: Single-center retrospective study.Setting: Tertiary referral hospital.Patients: Between,June 2003 and January 2010, 18 consecutive patients with PJS were enrolled.Main Outcome Measurements: Polyp detection rates among FE, VCE, and DBE, histology of resected polyps, and the polyp growth rate.Results: Total enteroscopy rate was higher at VCE (89%) than at DBE (52%; 27% in patients with >= 2 previous laparotomies and 90% in patients with 20 mm and in only 1.3% of polyps 10 mm (X1; P = .0366) and colorectal polyps >5 mm (X2; P = .002) were independent predictors of the growth rate of small-bowel polyps (Y), and a forward stepwise selection model was constructed: Y = 0.136 X X1 + 0.289 X X2 - 0.589 (R-2 = 0.665).Limitations: Small sample size.Conclusions: DBE and VCE were useful for the management of small-bowel polyps in PJS. VCE may replace barium examinations for surveillance after polyp resection at intervals depending on the polyp growth rate. (Gastrointest Enclose 2010;72:1209-16.)