Small-intestinal involvement in familial adenomatous polyposis

evaluation by double-balloon endoscopy and intraoperative enteroscopy

Takayuki Matsumoto, Motohiro Esaki, Ritsuko Yanaru-Fujisawa, Moriyama Tomohiko, Shinichiro Yada, Shotaro Nakamura, Takashi Yao, Mitsuo Iida

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Background: Small-intestinal adenoma occurs in patients with familial adenomatous polyposis (FAP). Objectives: The aim was to analyze the diagnostic yield of a double-balloon endoscopy (DBE) and an intraoperative enteroscopy (IOE) for small-intestinal involvement in FAP. Patients: Forty-one patients with FAP. Interventions: We examined 12 patients with FAP by using oral DBE before a colectomy and 29 patients with FAP by using IOE. The incidence and the endoscopic findings of adenoma were compared between the 2 procedures. Phenotypes of FAP and genotypes of adenomatous polyposis coli (APC) were then compared between patients with small-intestinal adenomas and those without. The genotype was classified into a 5' mutation (exons 1-14), a 3' mutation (exon 15), and a negative mutation of APC. Main Outcome Measurement: The prevalence of adenoma. Results: A DBE detected small-intestinal adenomas in 9 of 12 patients (75%), as did an IOE in 15 of 29 patients (52%, P > .05). The adenomas occurred predominantly in the jejunum, with a configuration of diminutive polyps in 22 patients. In addition, a DBE detected nonpolypoid adenoma in a patient, and nodular, broad-based protrusion (advanced lesions) in 3 patients, whereas an IOE detected advanced lesions in a patient. Patients with small-intestinal adenoma had more severe duodenal adenomatosis than those patients without small-intestinal adenoma (P < .001). In cases in which APC was analyzed, the prevalence of small-intestinal adenoma was higher in patients with a 3' mutation (100%) than in those with a 5' mutation (44%) and with a negative mutation (42%, P < .02). Limitation: Not a prospective randomized study. Conclusions: A DBE is equal to an IOE for scrutiny of small-intestinal adenomas in FAP. There seems to be a genotype-jejunal phenotype correlation in FAP.

Original languageEnglish
Pages (from-to)911-919
Number of pages9
JournalGastrointestinal Endoscopy
Volume68
Issue number5
DOIs
Publication statusPublished - Nov 1 2008

Fingerprint

Adenomatous Polyposis Coli
Endoscopy
Adenoma
Mutation
Exons
Genotype
Colectomy
Genetic Association Studies
Jejunum
Polyps

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Small-intestinal involvement in familial adenomatous polyposis : evaluation by double-balloon endoscopy and intraoperative enteroscopy. / Matsumoto, Takayuki; Esaki, Motohiro; Yanaru-Fujisawa, Ritsuko; Tomohiko, Moriyama; Yada, Shinichiro; Nakamura, Shotaro; Yao, Takashi; Iida, Mitsuo.

In: Gastrointestinal Endoscopy, Vol. 68, No. 5, 01.11.2008, p. 911-919.

Research output: Contribution to journalArticle

Matsumoto, Takayuki ; Esaki, Motohiro ; Yanaru-Fujisawa, Ritsuko ; Tomohiko, Moriyama ; Yada, Shinichiro ; Nakamura, Shotaro ; Yao, Takashi ; Iida, Mitsuo. / Small-intestinal involvement in familial adenomatous polyposis : evaluation by double-balloon endoscopy and intraoperative enteroscopy. In: Gastrointestinal Endoscopy. 2008 ; Vol. 68, No. 5. pp. 911-919.
@article{cb01fe6fb7dd4c2694873ebc552f3efd,
title = "Small-intestinal involvement in familial adenomatous polyposis: evaluation by double-balloon endoscopy and intraoperative enteroscopy",
abstract = "Background: Small-intestinal adenoma occurs in patients with familial adenomatous polyposis (FAP). Objectives: The aim was to analyze the diagnostic yield of a double-balloon endoscopy (DBE) and an intraoperative enteroscopy (IOE) for small-intestinal involvement in FAP. Patients: Forty-one patients with FAP. Interventions: We examined 12 patients with FAP by using oral DBE before a colectomy and 29 patients with FAP by using IOE. The incidence and the endoscopic findings of adenoma were compared between the 2 procedures. Phenotypes of FAP and genotypes of adenomatous polyposis coli (APC) were then compared between patients with small-intestinal adenomas and those without. The genotype was classified into a 5' mutation (exons 1-14), a 3' mutation (exon 15), and a negative mutation of APC. Main Outcome Measurement: The prevalence of adenoma. Results: A DBE detected small-intestinal adenomas in 9 of 12 patients (75{\%}), as did an IOE in 15 of 29 patients (52{\%}, P > .05). The adenomas occurred predominantly in the jejunum, with a configuration of diminutive polyps in 22 patients. In addition, a DBE detected nonpolypoid adenoma in a patient, and nodular, broad-based protrusion (advanced lesions) in 3 patients, whereas an IOE detected advanced lesions in a patient. Patients with small-intestinal adenoma had more severe duodenal adenomatosis than those patients without small-intestinal adenoma (P < .001). In cases in which APC was analyzed, the prevalence of small-intestinal adenoma was higher in patients with a 3' mutation (100{\%}) than in those with a 5' mutation (44{\%}) and with a negative mutation (42{\%}, P < .02). Limitation: Not a prospective randomized study. Conclusions: A DBE is equal to an IOE for scrutiny of small-intestinal adenomas in FAP. There seems to be a genotype-jejunal phenotype correlation in FAP.",
author = "Takayuki Matsumoto and Motohiro Esaki and Ritsuko Yanaru-Fujisawa and Moriyama Tomohiko and Shinichiro Yada and Shotaro Nakamura and Takashi Yao and Mitsuo Iida",
year = "2008",
month = "11",
day = "1",
doi = "10.1016/j.gie.2008.02.067",
language = "English",
volume = "68",
pages = "911--919",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "5",

}

TY - JOUR

T1 - Small-intestinal involvement in familial adenomatous polyposis

T2 - evaluation by double-balloon endoscopy and intraoperative enteroscopy

AU - Matsumoto, Takayuki

AU - Esaki, Motohiro

AU - Yanaru-Fujisawa, Ritsuko

AU - Tomohiko, Moriyama

AU - Yada, Shinichiro

AU - Nakamura, Shotaro

AU - Yao, Takashi

AU - Iida, Mitsuo

PY - 2008/11/1

Y1 - 2008/11/1

N2 - Background: Small-intestinal adenoma occurs in patients with familial adenomatous polyposis (FAP). Objectives: The aim was to analyze the diagnostic yield of a double-balloon endoscopy (DBE) and an intraoperative enteroscopy (IOE) for small-intestinal involvement in FAP. Patients: Forty-one patients with FAP. Interventions: We examined 12 patients with FAP by using oral DBE before a colectomy and 29 patients with FAP by using IOE. The incidence and the endoscopic findings of adenoma were compared between the 2 procedures. Phenotypes of FAP and genotypes of adenomatous polyposis coli (APC) were then compared between patients with small-intestinal adenomas and those without. The genotype was classified into a 5' mutation (exons 1-14), a 3' mutation (exon 15), and a negative mutation of APC. Main Outcome Measurement: The prevalence of adenoma. Results: A DBE detected small-intestinal adenomas in 9 of 12 patients (75%), as did an IOE in 15 of 29 patients (52%, P > .05). The adenomas occurred predominantly in the jejunum, with a configuration of diminutive polyps in 22 patients. In addition, a DBE detected nonpolypoid adenoma in a patient, and nodular, broad-based protrusion (advanced lesions) in 3 patients, whereas an IOE detected advanced lesions in a patient. Patients with small-intestinal adenoma had more severe duodenal adenomatosis than those patients without small-intestinal adenoma (P < .001). In cases in which APC was analyzed, the prevalence of small-intestinal adenoma was higher in patients with a 3' mutation (100%) than in those with a 5' mutation (44%) and with a negative mutation (42%, P < .02). Limitation: Not a prospective randomized study. Conclusions: A DBE is equal to an IOE for scrutiny of small-intestinal adenomas in FAP. There seems to be a genotype-jejunal phenotype correlation in FAP.

AB - Background: Small-intestinal adenoma occurs in patients with familial adenomatous polyposis (FAP). Objectives: The aim was to analyze the diagnostic yield of a double-balloon endoscopy (DBE) and an intraoperative enteroscopy (IOE) for small-intestinal involvement in FAP. Patients: Forty-one patients with FAP. Interventions: We examined 12 patients with FAP by using oral DBE before a colectomy and 29 patients with FAP by using IOE. The incidence and the endoscopic findings of adenoma were compared between the 2 procedures. Phenotypes of FAP and genotypes of adenomatous polyposis coli (APC) were then compared between patients with small-intestinal adenomas and those without. The genotype was classified into a 5' mutation (exons 1-14), a 3' mutation (exon 15), and a negative mutation of APC. Main Outcome Measurement: The prevalence of adenoma. Results: A DBE detected small-intestinal adenomas in 9 of 12 patients (75%), as did an IOE in 15 of 29 patients (52%, P > .05). The adenomas occurred predominantly in the jejunum, with a configuration of diminutive polyps in 22 patients. In addition, a DBE detected nonpolypoid adenoma in a patient, and nodular, broad-based protrusion (advanced lesions) in 3 patients, whereas an IOE detected advanced lesions in a patient. Patients with small-intestinal adenoma had more severe duodenal adenomatosis than those patients without small-intestinal adenoma (P < .001). In cases in which APC was analyzed, the prevalence of small-intestinal adenoma was higher in patients with a 3' mutation (100%) than in those with a 5' mutation (44%) and with a negative mutation (42%, P < .02). Limitation: Not a prospective randomized study. Conclusions: A DBE is equal to an IOE for scrutiny of small-intestinal adenomas in FAP. There seems to be a genotype-jejunal phenotype correlation in FAP.

UR - http://www.scopus.com/inward/record.url?scp=54449090364&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=54449090364&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2008.02.067

DO - 10.1016/j.gie.2008.02.067

M3 - Article

VL - 68

SP - 911

EP - 919

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 5

ER -