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Primary experience of small bowel polypectomy with balloon-assisted enteroscopy in young pediatric Peutz–Jeghers syndrome patients

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Abstract

For Peutz–Jeghers syndrome (PJS) patients, small bowel polyps develop and result in symptoms at an early age. Balloon-assisted enteroscopy (BAE) is verified as a safe and efficient choice to evaluate and remove small intestinal polyps in adult PJS. But the safety of BAE, especially BAE-facilitated polypectomy for young pediatrics, is little known. This prospective study focused on the effectiveness and safety of BAE-facilitated polypectomy in small bowel for young pediatric PJS. PJS patients (aged 0–14 years old) with BAE (including both single-balloon and double-balloon enteroscopies) were included from 1 September 2012 to 30 April 2018. The demographic data, medical history, and details of BAE were recorded. BAE-related complications and symptom relief after BAE were evaluated and compared between the PJS patients aged 5–10 years old (the younger pediatric group) and those aged 11–14 years old (the older pediatric group). A total of 41 pediatric PJS patients (5–14 years old) subjected to 82 BAEs were included. BAE-facilitated polypectomy was performed for 33 children (80.5%), and 242 polyps in small bowel were removed. For 10 (24.4%) patients, one or more giant polyps (maximum diameter larger than 5 cm) were removed. For eight patients, no polypectomy was done as no polyps were observed (six subjects) or not suitable for BAE-facilitated polypectomy (two subjects) because of high risk of perforation. The complication rates of BAE and BAE-facilitated polypectomy were 1.2% (1/82) and 1.8% (1/55), and the symptom relief rate was 70.8% (17/24). Compared with the older pediatric group, the younger pediatric group showed no increased BAE complication rate (0.0% vs. 5.0%, p = 0.488) and a comparable rate of symptom relief after BAE therapy (80.8% vs. 55.6%, p = 0.356).

Conclusion: BAE-facilitated polypectomy in young pediatric PJS is safe and effective.

What is known:

• Small bowel evaluation and prophetic polypectomy are important for pediatric PJS patients to avoid polyp-related intussusception, obstruction, and bleeding.

• BAE polypectomy was a recommended intervention for removing small bowel polyps in adult PJS patients.

What is new:

• BAE-facilitated small bowel polypectomy is safe and effective for young pediatric PJS, even for those aged less than 10 years old.

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Abbreviations

BAE:

Balloon-assisted enteroscopy

PJS:

Peutz–Jeghers syndrome

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Authors and Affiliations

  1. Department of Gastroenterology, Air Force Medical Center, The Fourth Military Medical University, PLA, NO.30 Fucheng Road, Beijing, 100023, China

    Bai-Rong Li, Tao Sun, Jing Li, Yan-Shuang Zhang, Shou-Bin Ning, Xiao-Wei Jin, Ming Zhu & Gao-Ping Mao

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  1. Bai-Rong Li
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  2. Tao Sun
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  3. Jing Li
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  4. Yan-Shuang Zhang
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  6. Xiao-Wei Jin
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  7. Ming Zhu
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Contributions

Bai-Rong Li, Tao Sun, Jing Li, and Yan-Shuang Zhang participated in the acquisition, analysis, and interpretation of data, as well as in drafting the manuscript, Xiao-Wei Jin and Ming Zhu and Gao-Ping Mao participated in data acquisition and manuscript drafting, and Shou-Bin Ning contributed to conceptualization, design, and data interpretation as well as revised the manuscript for important intellectual content.

Corresponding author

Correspondence to Shou-Bin Ning.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Ethics Committee of Air Force Medical Center, PLA, China.

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Informed consent was obtained from all individual participants included in the study.

Additional information

Communicated by Peter de Winter

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Li, BR., Sun, T., Li, J. et al. Primary experience of small bowel polypectomy with balloon-assisted enteroscopy in young pediatric Peutz–Jeghers syndrome patients. Eur J Pediatr 179, 611–617 (2020). https://doi.org/10.1007/s00431-019-03534-1

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  • DOI: https://doi.org/10.1007/s00431-019-03534-1

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