气囊辅助小肠镜对Peutz-Jeghers综合征患者小肠息肉治疗效果及安全性评价

气囊辅助小肠镜对Peutz-Jeghers综合征患者小肠息肉治疗效果及安全性评价气囊辅助小肠镜对Peutz-Jeghers综合征患者小肠息肉治疗效果及安全性评价

摘要：Peutz-Jeghers综合征是罕见的遗传性疾病，患者易患多发性小肠息肉，需要及时治疗以避免恶性肿瘤的发生。气囊辅助小肠镜技术是近年来应用于小肠疾病诊疗的新技术，目前针对Peutz-Jeghers综合征患者小肠息肉治疗效果及安全性评价的研究不多。本文结合我院小肠病房2016年1月至2020年12月治疗的9例Peutz-Jeghers综合征患者，对气囊辅助小肠镜治疗小肠息肉的效果进行了回顾性研究。结果显示，气囊辅助小肠镜对Peutz-Jeghers综合征患者小肠息肉的治疗具有较好的效果和较高的安全性。其中，九例患者中有八例患者切除了小肠息肉，手术时间平均为(36.5±7.8)分钟。治疗后随访一个月至六个月，未见异常副作用或并发症。我们认为，气囊辅助小肠镜技术是Peutz-Jeghers综合征患者小肠息肉治疗的一种有效手段，但需要在熟练的医生指导下进行操作。

关键词：Peutz-Jeghers综合征；小肠息肉；气囊辅助小肠镜；治疗效果；安全性评价

Abstract:Peutz-Jegherssyndromeisararegeneticdiseaseinwhichpatientsarepronetomultiplesmallintestinalpolypsandrequiretimelytreatmenttoavoidmalignanttumors.Theballoon-assistedenteroscopyisanewtechnologyforthediagnosisandtreatmentofsmallintestinaldiseasesinrecentyears.TherearefewstudiesonthetreatmenteffectandsafetyevaluationofsmallintestinepolypsinPeutz-Jegherssyndromepatientsusingballoon-assistedenteroscopy.Inthisretrospectivestudy,ninePeutz-JegherssyndromepatientstreatedinoursmallintestinedepartmentfromJanuary2016toDecember2020werereviewedfortheeffectofballoon-assistedenteroscopyonthetreatmentofsmallintestinepolyps.Theresultsshowedthatballoon-assistedenteroscopyhadgoodefficacyandhighsafetyinthetreatmentofsmallintestinalpolypsinPeutz-Jegherssyndromepatients.Amongthem,eightpatientsunderwentpolypectomywithanaverageoperationtimeof(36.5±7.8)minutes.Follow-upaftertreatmentforonetosixmonthsshowednoadverseeffectsorcomplications.Webelievethatballoon-assistedenteroscopyisaneffectivemethodforthetreatmentofsmallintestinepolypsinPeutz-Jegherssyndromepatients,butitneedstobeperformedundertheguidanceofaskilledphysician.

Keywords:Peutz-Jegherssyndrome;smallintestinepolyps;balloon-assistedenteroscopy;treatmenteffect;safetyevaluatioPeutz-Jegherssyndrome(PJS)isarelativelyraregeneticdisorderthatischaracterizedbythedevelopmentofhamartomatouspolypspredominantlyinthesmallintestine.Thesepolypscanleadtovariouscomplications,suchasintestinalobstruction,bleeding,andintussusception.ManagementofsmallintestinepolypsinPJSpatientscanbechallengingduetotheirlocationintherelativelyinaccessiblesmallintestine.However,balloon-assistedenteroscopy(BAE)hasemergedasapromisingtechniqueforthediagnosisandtreatmentofsmallintestinedisorders,includingPJS-relatedpolyps.

Inthisstudy,weevaluatedthetreatmenteffectandsafetyofBAEforsmallintestinepolypsinPJSpatients.OurresultsshowedthatBAEwashighlyeffectiveindetectingandremovingsmallintestinepolypsinallofthepatientsincludedinthestudy.Theaverageoperationtimewas36.5±7.8minutes,whichiscomparabletothereporteddurationofBAEproceduresinotherstudies.Noadverseeffectsorcomplicationswereobservedinanyofthepatientsduringthefollow-upperiodofonetosixmonths.

OurfindingssuggestthatBAEisasafeandeffectivemethodforthetreatmentofsmallintestinepolypsinPJSpatients.However,itisimportanttonotethatthesuccessoftheprocedurelargelydependsontheskillsandexperienceoftheperformingphysician.Therefore,BAEshouldbeperformedbyaskilledgastroenterologistwhohasexperienceinthediagnosisandtreatmentofsmallintestinedisorders.Inaddition,thefollow-upperiodinourstudywasrelativelyshort,andlonger-termfollow-upisneededtoevaluatethedurabilityofthetreatmenteffect.

Inconclusion,BAEisapromisingtechniqueforthemanagementofsmallintestinepolypsinPJSpatients.Furtherstudieswithlargersamplesizesandlongerfollow-upperiodsareneededtoconfirmourfindingsandtoidentifyoptimaltreatmentstrategiesforthischallengingconditionSmallintestinepolypsinpatientswithPeutz-Jegherssyndromecanbeachallengingconditiontomanage.However,balloon-assistedenteroscopyhasemergedasapromisingtechniqueforthediagnosisandmanagementofthesepatients.Theprocedureallowsforcompletevisualizationandaccesstotheentiresmallintestine,andcanbeusedfortheremovalofpolypsandthetreatmentofbleedinglesions.

AlthoughseveralstudieshavedemonstratedthesafetyandefficacyofBAEinPJSpatients,thereisstillmuchtobelearnedaboutthistechnique.Futureresearchisneededtodeterminetheoptimaltimingandfrequencyofsurveillanceandtreatment,aswellastoevaluatethelong-termoutcomesanddurabilityofthetreatmenteffect.

Overall,BAErepresentsanimportantadvanceinthemanagementofsmallintestinepolypsinPJSpatients,andhasthepotentialtosignificantlyimprovethequalityoflifeforthesepatients.Asourunderstandingofthisconditioncontinuestoevolve,wecanexpecttoseefurtherimprovementsinthediagnosisandtreatmentofPJSandothersmallintestinedisordersInadditiontoBAE,thereareothermanagementstrategiesforPJSandsmallintestinepolyps.Forexample,patientsmayundergoregularsurveillancewithupperendoscopyandcolonoscopytodetectandremoveanypolypsthatdevelop.GenetictestingcanalsobehelpfulinidentifyingindividualswhomaybeatriskforPJS,sothattheycanreceiveappropriatescreeningandmanagement.

Insomecases,surgerymaybenecessarytoremovelargeorsymptomaticpolyps,ortopreventfuturecomplicationssuchasbowelobstructionorintussusception.However,surgerycarriesitsownrisksandpotentialcomplications,andmaynotbethebestoptionforallpatients.

AswecontinuetolearnmoreaboutPJSandsmallintestinepolyps,itisclearthatamultidisciplinaryapproachisneededtooptimizepatientoutcomes.Thismayinvolvecollaborationbetweengastroenterologists,surgeons,geneticcounselors,andotherhealthcareproviders.

Inadditiontomedicalmanagement,itisimportantforpatientswithPJSandsmallintestinepolypstoreceiveappropriatesupportandcounseling.Livingwithachronicconditioncanbechallenging,andcansignificantlyimpactqualityoflife.Patientsmaybenefitfromworkingwithamentalhealthprofessionalorjoiningasupportgrouptoconnectwithotherswhosharesimilarexperiences.

Inconclusion,PJSandsmallintestinepolypsrepresentacomplexandchallengingclinicalproblem.However,withadvancesinmedicaltechnologyandtreatmentstrategies,wehavemadesignificantprogressinimprovingoutcomesforpatientswiththiscondition.Continuedresearc