Contribution of capsule endoscopy to Peutz-Jeghers syndrome management in children

Gastineau, Swellen; Viala, Jérôme; Caldari, Dominique; Mas, Emmanuel; Darviot, E.; Gall, Catherine Le; Maurage, C.; Michaud, Laurent; Dabadie, A.

doi:10.1016/j.dld.2012.05.018

Cited by 26 publications

(18 citation statements)

References 24 publications

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“…WCE and SBE play an important role in surveillance of patients affected by PJS. WCE is safe, well tolerated and permits to detect size, aspect and location of polyps on the entire length of the digestive tube [10,11] . In our series, all patients received upper endoscopy, ileocolonoscopy and WCE to detect polyps' location and size before SBE procedure.…”

Section: Discussionmentioning

confidence: 99%

Conservative approach in Peutz-Jeghers syndrome: Single-balloon enteroscopy and small bowel polypectomy

Torroni

Romeo

Rea

et al. 2014

WJGE

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AIM:To assess the usefulness of the balloon assisted enteroscopy in preventing surgical intervention in patients with Peutz-Jeghers syndrome (PJS) having a small bowel large polyps. METHODS:Seven consecutive asymptomatic pts (age 15-38 years) with PJS have been collected; six underwent polypectomy using single balloon enteroscopy (Olympus SIF Q180) with antegrade approach using push and pull technique. SBE system consists of the SIF-Q180 enteroscope, an overtube balloon control unit (OBCU Olympus Balloon Control Unit) and a disposable silicone splinting tube with balloon (ST-SB1). All procedures were performed under general anesthesia. Previously all pts received wireless capsule endoscopy (WCE). Prophylactic polypectomy was reserved mainly in pts who had polyps > 15 mm in diameter. The balloon is inflated and deflated by a balloon control unit with a safety pressure setting range from -6.0 kPa to +5.4 kPa. Informed consent has been obtained from pts or parents for each procedure. RESULTS:Six pts underwent polypectomy of small bowel polyps; in 5 pts a large polyp > 15 mm (range 20-50 mm in diameter) was resected; in 1 patient with WCE negative, SBE was performed for previous surgical resection of gastrointestinal stromal tumors. In 2 pts endoscopic clips were placed due to a polypectomy. No surgical complication have been reported. SBE with resection of small bowel large polyps in PJS pts was useful to avoid gastrointestinal bleeding and emergency laparotomy due to intestinal intussusceptions. No gastrointestinal tumors were found in subsequent enteroscopic surveillance in all seven pts. In order surveillance, all pts received WCE, upper endoscopy, ileocolonoscopy every 2 years. No pts had extraintestinal malignant lesions. SBE was performed when WCE was positive for significant polyps (> 15 mm). CONCLUSION:The effective of prophylactic polypectomy of small bowel large polyps (> 15 mm) could be the first line treatment for conservative approach in management of PJS patients. small bowel large polyps is useful to avoid emergency laparotomy after performing wireless capsule endoscopy. The effective of prophylactic polypectomy of small bowel large polyps could be the first line treatment for conservative approach in management of PJS patients.

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Section: Discussionmentioning

confidence: 99%

Conservative approach in Peutz-Jeghers syndrome: Single-balloon enteroscopy and small bowel polypectomy

Torroni

Romeo

Rea

et al. 2014

WJGE

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“…In both males and females examination of the small bowel is recommended (small intestine passage) beginning at the 8th year of age, every two-three years. Reports are available on the advantageous role of capsule endoscopy but the number of tests that have been performed is still insufficient to recommend the approach in the form of management recommendations [48]. Extensive diagnostic and therapeutic hopes may be founded on double-balloon endoscopy, allowing unitemporal polypectomies in necessary cases [49].…”

Section: Introductionmentioning

confidence: 99%

Hamartomatous polyposis syndromes

Stojčev

Borun

Hermann

et al. 2013

Hered Cancer Clin Pract

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Hamartomas are tumour-like malformations, consisting of disorganized normal tissues, typical of the site of tumour manifestation. Familial manifestation of hamartomatous polyps can be noted in juvenile polyposis syndrome (JPS), Peutz-Jeghers’ syndrome (PJS), hereditary mixed polyposis syndrome (HMPS) and PTEN hamartoma tumour syndrome (PHTS). All the aforementioned syndromes are inherited in an autosomal dominant manner and form a rather heterogenous group both in respect to the number and localization of polyps and the risk of cancer development in the alimentary tract and other organs. Individual syndromes of hamartomatous polyposis frequently manifest similar symptoms, particularly during the early stage of the diseases when in several cases their clinical pictures do not allow for differential diagnosis. The correct diagnosis of the disease using molecular methods allows treatment to be implemented earlier and therefore more effectively since it is followed by a strict monitoring of organs that manifest a predisposition for neoplastic transformation.

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“…CE obviously allowed major implications for the diagnosis, therapeutic decision‐making, and outcomes in the management of obscure gastrointestinal (GI) bleeding . Recently, the availability of CE for other clinical conditions, including hereditary polyposis syndrome, malabsorption syndrome, and inflammatory bowel diseases, have been increasingly reported. In Crohn's disease (CD), a growing body of evidence shows a favorable diagnostic yield of CE ranging between 58% and 71%, and a recent meta‐analysis confirmed significantly higher diagnostic yields of CE when compared with small bowel radiography, computed tomography (CT) enterography, or magnetic resonance enterography .…”

Section: Introductionmentioning

confidence: 99%

Use of capsule endoscopy in patients with Crohn's disease in Japan: A multicenter survey

Esaki

Matsumoto

Watanabe

et al. 2013

J of Gastro and Hepatol

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Contribution of capsule endoscopy to Peutz-Jeghers syndrome management in children

Cited by 26 publications

References 24 publications

Conservative approach in Peutz-Jeghers syndrome: Single-balloon enteroscopy and small bowel polypectomy

Conservative approach in Peutz-Jeghers syndrome: Single-balloon enteroscopy and small bowel polypectomy

Hamartomatous polyposis syndromes

Use of capsule endoscopy in patients with Crohn's disease in Japan: A multicenter survey

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