Combined endoscopic and surgical treatment for the polyposis of Peutz-Jeghers syndrome

Lin, Being-Chuan; Lien, Jau Min; Chen, R.-J.; Fang, Ji‐Tseng; Wong, Yon-Cheong

doi:10.1007/s004640000029

Cited by 41 publications

(26 citation statements)

References 14 publications

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“…Involvement of the colon (53% of patients), stomach (49%), and rectum (32%) is also seen [15,[33][34][35] . Well-timed polypectomy may obviate the need for repeated urgent operations and extensive small bowel resections leading to short bowel syndrome [39,40] . Extraintestinal polyps are also reported.…”

Section: History Of the Diseasementioning

confidence: 99%

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Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach

Kopáčová

Tachecí²,

Rejchrt³

et al. 2009

WJG

193

183

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Peutz-Jeghers syndrome (PJS) is an inherited, autosomal dominant disorder distinguished by hamartomatous polyps in the gastrointestinal tract and pigmented mucocutaneous lesions. Prevalence of PJS is estimated from 1 in 8300 to 1 in 280 000 individuals. PJS predisposes sufferers to various malignancies (gastrointestinal, pancreatic, lung, breast, uterine, ovarian and testicular tumors). Bleeding, obstruction and intussusception are common complications in patients with PJS. Double balloon enteroscopy (DBE) allows examination and treatment of the small bowel. Polypectomy using DBE may obviate the need for repeated urgent operations and small bowel resection that leads to short bowel syndrome. Prophylaxis and polypectomy of the entire small bowel is the gold standard in PJS patients. Intraoperative enteroscopy (IOE) was the only possibility for endoscopic treatment of patients with PJS before the DBE era. Both DBE and IOE facilitate exploration and treatment of the small intestine. DBE is less invasive and more convenient for the patient. Both procedures are generally safe and useful. An overall recommendation for PJS patients includes not only gastrointestinal multiple polyp resolution, but also regular lifelong cancer screening (colonoscopy, upper endoscopy, computed tomography, magnetic resonance imaging or ultrasound of the pancreas, chest X-ray, mammography and pelvic examination with ultrasound in women, and testicular examination in men). Although the incidence of PJS is low, it is important for clinicians to recognize these disorders to prevent morbidity and mortality in these patients, and to perform presymptomatic testing in the first-degree relatives of PJS patients.

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Section: History Of the Diseasementioning

confidence: 99%

“…Moreover, it is necessary to have close collaboration with a surgeon in case of complications. Complete polypectomy in IOE or DBE can provide a longer symptom-free interval [39,40,77] . In the series published to date, complications of DBE solely relating to the diagnostic procedure are rare.…”

Section: Overall Experience Of Pjs Patientsmentioning

confidence: 99%

Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach

Kopáčová

Tachecí²,

Rejchrt³

et al. 2009

WJG

193

183

View full text Add to dashboard Cite

show abstract

“…Moreover, it is necessary to have close collaboration with a surgeon in case of complications. Complete polypectomy in both events-IOE or DBE-provide a longer symptomfree interval [16,17].…”

Section: Resultsmentioning

confidence: 99%

“…Polyps occur most commonly 24:1904-1910 1905 in the small intestine (64%), although involvement of the colon (53%), stomach (49%), and rectum (32%) also is seen [7]. Well-timed polypectomy may obviate the need for repeated urgent operations and extensive small-bowel resections, which leads to short-bowel syndrome [16,17]. Double-balloon enteroscopy (DBE) is a new enteroscopy method that allows examination and treatment of the jejunum and ileum in almost all patients.…”

mentioning

confidence: 99%

Comparison of intraoperative enteroscopy and double-balloon enteroscopy for the diagnosis and treatment of Peutz-Jeghers syndrome

et al. 2010

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Polypectomy using DBE may obviate the need for repeated urgent operations and small-bowel resections leading to short-bowel syndrome. Patients are indicated for prophylactic procedure and polypectomy of the entire small bowel. Both DBE and IOE facilitate exploration and treatment of the small intestine. DBE is less invasive and more convenient for the patient. Both procedures are generally safe and useful.

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“…Combining laparotomy with endoscopy allows manipulation to ensure the entire small bowel is visualized and nearly all polyps are removed [42][43][44][45]. Enterotomies may be used to access and remove identified small bowel polyps [46,47]. Alternatively, endoscopic polypectomy may be utilized to avoid additional enterotomies [48].…”

Section: Malignancy Riskmentioning

confidence: 99%

Intussusception in the adult: an unsuspected case of Peutz–Jeghers syndrome with review of the literature

et al. 2008

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Peutz-Jeghers syndrome is an uncommon genetic defect in the signal pathways of growth. The incidence has most recently been estimated to be in the range of 1 per 120,000 live births [1]. It is characterized by hamartomas throughout the gastrointestinal tract, mucocutaneous melanotic spots and increased predisposition to malignancy. The infrequent presentation of this syndrome in most practice combined with some less well-known diagnostic features may contribute to a misdiagnosis. Further, understanding of the genetic defect leading to the phenotypic syndrome and the future implications of this defect continue to evolve. Therefore we present a review in the setting of a case of misdiagnosed Peutz-Jeghers syndrome to portray illuminating features of the syndrome and review the literature.

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Combined endoscopic and surgical treatment for the polyposis of Peutz-Jeghers syndrome

Abstract: Repeat TES is a safe and effective method for treating both an unsuccessful sympathectomy and recurrent palmar or axillary hyperhidrosis.

Cited by 41 publications

References 14 publications

Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach

Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach

Comparison of intraoperative enteroscopy and double-balloon enteroscopy for the diagnosis and treatment of Peutz-Jeghers syndrome

Intussusception in the adult: an unsuspected case of Peutz–Jeghers syndrome with review of the literature

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