What Is the Endoscopic Treatment for Peutz-Jeghers Syndrome Polyps?
Peutz-Jeghers syndrome is associated with polyp growth throughout the gastrointestinal tract — including the small intestine, stomach, and colon. Endoscopic resection of these polyps is the central management strategy, aimed at preventing complications from ongoing polyp growth.
Treatment Approach
The recommended approach is endoscopic resection of Peutz-Jeghers polyps, with polypectomy technique selected based on the location of the polyp within the gastrointestinal tract. Balloon-assisted enteroscopy is involved for small intestinal polyps. The specific criteria governing when and how resection is performed — including size thresholds, symptom considerations, and deep small-intestinal technique alternatives — are detailed in the full protocol.
References
DOI: 10.1159/000529799
- Peutz-Jeghers polyps can be resected endoscopically to avoid symptoms associated with their growth.
- Resection of polyps larger than 15 mm (10 mm, if possible) is strongly recommended.
- In terms of treatment, guidelines published by the JGES and the European Society of Gastrointestinal Endoscopy (ESGE) strongly recommend polypectomy using BAE for small intestinal polyps larger than 10–15 mm confirmed by SBCE or other imaging studies.
- Polyps larger than 10–15 mm, symptomatic polyps, and rapidly growing polyps should be resected, and polyps smaller than 10–15 mm may be considered for resection, while the procedure is easy as they are expected to grow in the future.
- Deep within the small intestine, it is inevitably difficult to maneuver BAE to apply a snare to the stalk of the polyp, and ischemic polypectomy using a detachable snare or clip has been described.
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