| Objective : To investigate the clinical value and safety and feasibility of balloon assisted enteroscopy(BAE)for the treatment of small bowel polyps in patients with Peutz-Jeghers syndrome(PJS).Methods: Clinical data of 200 patients with PJS treated by BAE in Air Force General Hospital of Chinese PLA from April.2004 to July.2015 were analyzed retrospectively.Results:1.General information: between April 2004 and July 2004 of 200 patients with PJS in air force general hospital,among which 110 were male,female 90 cases,male:female ratio is 1.22:1,7-57 years old age range,median age 25 years old.Of the200 patients,80 cases(40%)patients with positive family history,120 cases(60%)for sending out.All the patients were in accordance with the national implementation scheme of hereditary colorectal cancer screening criteria in Peutz-Jeghers syndrome diagnostic criteria.2.Were analyzed for the first time: this group of 200 patients,156 patients with abdominal pain or discomfort for the first time to see a doctor;Only 14 patients with oral mucosa pigmentation visits;30 patients with black or bloody and attendance.3.Clinical symptoms:251 cases had obvious clinical symptoms before treatment,among them 65 cases of incomplete intestinal obstruction,abdominal pain and abdominal discomfort,156 cases,30 cases of gastrointestinal bleeding.4.Surgery previous medical history: Of the 200 patients with PJS,129(64.5%)patients undergoing BAE before examination and treatment for intestinal obstruction,intussusception,or bowel perforation treated with surgical operation on one or more(up to four times in 2 cases,9 cases 3 times,2 times,41 cases were77 cases of 1).Has a history of 71 patients with no surgery,of the first line of surgical treatment in this age range for 3-45.5.Airbag auxiliary enteroscopy polyps treatment: a total of 200 patients with 200 cases of BAE examination and treatment,including 212 cases through anal entry,438 cases,transoral approach into the microscopic resection of small bowel polyps in 2923,5 ~ 10 mm diameter of 632(21.3%),1597(54.6%),11 ~ 30 mm diameter31 ~ 50 mm 557(19.1%),more than 50 mm diameter 137(4.7%).6.Outcome:186 cases(186/251)after treatment the symptoms disappeared or significantly.The endoscopic treatment of complications occurred 18 cases,including 9 cases of small intestine perforation,and 9 cases of gastrointestinal bleeding.BAE after polypectomy transient mild abdominal pain or discomfort in the incidence of 80.1%(523/650),postoperative 1 case was complicated with pancreatitis,discover polyp canceration in 5 cases,endoscopic no treatment-related deaths.7.The pathologic result: Group,200 patients with PJS are clear pathological results:166 cases of pathological histology characteristics in hamartoma polyps,19 cases of merger villi gland tubular adenoma.5 cases of polyp canceration,inflammatory polyp of 17 cases,12 cases adenomatous polyp.8.The hospitalization days and recovery time of gastrointestinal motility after surgery of BAE therapy and operation therapy in 35 cases were analyzed by paired samples t test and the result was statistically significant.Conclusion : More than ever in the treatment of intestinal polyps of PJS rely on surgical treatment.In recent years,balloon assisted enteroscopy provide a new method for the treatment of PJS intestinal polyps,this study suggests that BAE in the treatment of patients with PJS intestinal polyp is safe and effective,and can be repeatedly for inspection,the advantages of small trauma and quicker recovery of gastrointestinal function,for most of the patients with PJS avoids multiple lines of surgical treatment of pain and sufferings,alternative to surgery,to a certain extent,in the treatment of patients with PJS intestinal polyp provides a new diagnostic methods.In patients with PJS follow-up and treatment of small intestinal polyp has good clinical value. |
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