术中内镜治疗黑斑息肉综合征小肠息肉疗效观察

Minimal incision laparotomy assisted endoscopic resection for polyps in small intestine in patients with Peutz-Jeghers syndrome

目的探讨小切口开腹术配合内镜治疗黑斑息肉综合征（PJS）小肠多发息肉的疗效。方法对临床诊断为PJS的患者进行小肠多发息肉的术中内镜治疗，主要观察指标包括内镜下息肉治疗的完成情况、小肠息肉切除的数量、大小以及与内镜下治疗相关的并发症等。结果8例患者共在术中切除812枚息肉，直径〈10mm384枚；10～30mm 356枚；〉30mm 72枚，其中最大者45mm×38mm。术后出现肠功能障碍1例，腹部隐痛不适1例，未引起血色素下降的出血及其他严重并发症发生。结论术中内镜治疗能安全可靠地切除PJS患者深部小肠息肉，对小肠息肉的治疗损伤小、恢复快，具有重要的临床应用价值。

Objective To evaluate the effectiveness and safety of minimal incision laparotomy assisted endoscopic resection for polyps in small intestine in patients with Peutz-Jeghers syndrome. Methods The clinical data of patients with Peutz-Jeghers syndrome, who underwent minimal incision laparotomy assis- ted endoscopic resection for polyps in small intestine, were retrospectively studied. The size and number of the endoscopically resected polyps, and the procedure related complications were documented. Results A total of 812 polyps in small-bowel were resected in 8 patients, in which 384 were smaller than 10mm, 356 with diameter ranging from 11 mm to 30mm, and 72 were larger than 30mm in diameter. Procedure related complications included intestinal dysfunction in 1 patient and abdominal pain in another. No bleeding with a fall in Hb or other severe complications were observed. Conclusion Minimal incision laparotomy assisted endoscopic resectio is a safe and reliable procedure for the treatment of mid-small bowel polyps in patients with Peutz-Jeghers syndrome. It revolutionizes the therapeutic options for polyps in the region of the midsmall bowel and limits the indications for primary surgical management.