Selective ligation using a detachable snare for small-intestinal polyps in patients with Peutz–Jeghers syndrome

Abstract

Peutz–Jeghers syndrome (PJS) is a rare autosomal dominant hereditary disorder with an incidence of 1/200 000 live births. It is partly characterized by hamartomatous polyps of the gastrointestinal tract. The risk of malignant transformation in these polyps increases with polyp size, with cancer occurring in 15 % of polyps more than 3 cm in diameter [1]. Hamartomatous polyps are detected in 88 % of patients with PJS, mostly in the small intestine. We evaluated the therapeutic efficacy, clinical impact, and safety of selective ligation using a detachable snare for small-intestinal polyps in three patients with PJS. For larger polyps, this technique is safer than conventional snare polypectomy or endoscopic mucosal resection (EMR) because it minimizes the risks of postpolypectomy bleeding, thermal injury to deeper tissue layers, and perforation.