Therapeutic Study Of Small-bowel Polyps By Balloon-assisted Enteroscopy

Objective To explore the feasibility, safety and clinical value of endoscopic polypectomy of small-bowel polyps by balloon-assisted enteroscopy.Methods A retrospective analysis was conducted on the clinical data of 199 cases in Air Force General Hospital, PLA from August 2006 to July 2014. The data included general information such as age, gender, operation history, family history, the first symptoms, and the details of endoscopic polypectomy treatment in 199 patients:the way, inserted depth, examination times of BAE, the number, shape, size and histological pathology of small-bowel polyps resected by balloon-assisted enteroscopy, postoperative complications and the treatments for complications. Compaired the hospitalization days, expense and recovery time of gastrointestinal motility after surgery of BAE therapy and operation therapy in 32 cases to evaluate the feasibility, safety and clinical application value of BAE. All data were analyzed statistically by SPSS 19.0.Results 1.199 cases of small-bowel polyps included 110 male cases and 89 female cases.179 patients were diagnosed with Peutz-Jeghers syndrome and 3 cases were confirmed with familial adenomatous polyposis while other 17 patients were jejunoileal polyposis.2.199 patients underwent 558 times endoscopic examination and therapy and resected 3391 small-bowel polyps successfully, including 801 (23.62%) polyps of 5-10mm diameter,1887(55.65%) of 11-30mm diameter,563(16.60%) of 31-50mm diameter and 140(4.13%) polyps bigger than 50mm, and the maximum is about 7cm* 10cm. Pedunculated polyps were 2945 (86.84%), and sessile polyps were 446 (13.16%). 5 cases turned into malignant tumors while 2 cases had lymph node metastasis and 1 case had peritoneal and hepatic metastasis.3. Postoperative transient mild abdominal pain, abdominal discomfort, nausea, vomiting and other symptoms happened in 437 cases, the incidence was 78.32%. There were 21 cases (3.76%) of severe postoperative complications:postoperative bleeding was observed in 15 cases. Surgical operation hemostatic treatment was implemented in 1 case and 2 cases underwent endoscopic hemostatic therapy. All the rest had got the conservative treatment with medicine. Intestinal perforation occurred in 6 cases and surgical operations were taken for complication therapy. No operation related death cases.4. The hospitalization days, expense and recovery time of gastrointestinal motility after surgery of BAE therapy and operation therapy in 32 cases were analyzed by paired samples t test and the result was statistically significant.Conclusion BAE is a safe and efficient option for the resection of small-bowel polyps. Its outstanding advantage is can be repeated many times, especially for multiple polyps. Through times of endoscopic therapy, all polyps can be receted. Compared with surgical operation, BAE has more advantages including less incidence of postoperative complications, smaller trauma, higher safety and lower treatment cost. For the majority of small bowel polyps patients, it can replace the surgical operation as the preferred method of treatment and has giant clinical application value and development prospects.