セッション情報 International Session7(消化器内視鏡学会・消化器病学会合同)

Small bowel endoscopy-Where are we,and where to go?

タイトル 内IS7-12:

Clinical impact of capsule endoscopy in hereditary polyposis syndromes

演者 M. Esaki(Department of Medicine and Clinical Science, Kyushu University)
共同演者 Y. Maehata(Department of Medicine and Clinical Science, Kyushu University), T. Matsumoto(Department of Medicine and Clinical Science, Kyushu University)
抄録 Objective: We aimed to investigate clinical impact of capsule endoscopy (CE) in patients with hereditary polyposis syndromes.
Subjects: 15 patients with familial adenomatous polyposis (FAP) and 4 patients with Peutz-Jeghers syndrome (PJS).
Methods: In FAP, small bowel lesions were classified into 3 groups according to CE findings; none (-), <5 (+), and >5 (++). Under EGD, duodenal lesions were graded by Spigelman classification, and the correlation between small bowel lesions and duodenal lesions was analyzed. In PJS, large polyps presumably indicated for polypectomy were counted under CE, and the findings were compared with those of double-balloon endoscopy (DBE).
Results: In FAP, small bowel lesions were found under CE in 8 patients, 2 of whom were classified into group (++). In 8 patients having duodenal lesions of Spigelman's stage I/II, small bowel lesions were found in 3, while CE revealed small bowel lesions in all patients having duodenal lesions of Spigelman's stage III/IV. In PJS, CE revealed large polyps in 4 patients, whereas DBE identified more number of polyps in 3 of the 4 patients. Polyps were subsequently resected in 3 patients, one being intraoperatively and the other two being under DBE.
Conclusion: CE may be appropriate for FAP patients with severe duodenal lesions. In PJS, CE seems useful for the surveillance of small bowel polyps, however, certain proportion of large polyps can be missed under CE.
索引用語 capsule endoscopy, hereditary polyposis syndrome