Intraoperative Enteroscopic Total Polypectomy for the Patients with Peutz-Jeghers Syndrome

ABSTRACT

Patients with Peutz-Jeghers syndrome often suffer complications of the polyps, such as intussusception, bowel obstruction, and bleeding. Furthermore, repeated operations may be required in some patients, which may result in short-bowel syndrome. Intraoperative enteroscopy during a laparotomy for this syndrome was introduced. This can avert multiple enterotomies and decrease bowel resection segments. We report the cases of three consecutive patients with Peutz-Jeghers syndrome who recently underwent intraoperative enteroscopy via enterotomy with successful removal of most small-bowel polyps. The large polyps of the jejunum required an enterotomy for their removal, but smaller polyps at the lower ileum were identified and removed by using intra-operative total enteroscopy. A more complete polypectomy can be performed using this technique, thus allowing patients with Peutz- Jeghers syndrome a longer interval between laparotomies and a reduction in the symptoms attributed to polyps.