{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T07:39:10Z","timestamp":1767339550120,"version":"3.37.3"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"12","license":[{"start":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T00:00:00Z","timestamp":1695600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n            Background and study aims Small-bowel polyps in patients with Peutz\u2013Jeghers syndrome (PJS) are sometimes difficult to reach using double-balloon enteroscopy (DBE). However, they can induce intussusception, especially when \u226715 mm. This study aimed to review the outcomes of patients with such polyps.<\/jats:p><jats:p>\n            Patients and methods All patients with PJS with small-bowel polyps that bidirectional DBE failed to reach and were \u22675 mm as shown by DBE enterography at our institution from May 2006 to April 2022 were retrospectively evaluated. The endpoint was the earliest occurrence of symptomatic intussusception induced by the polyp, endoscopic removal by repeat DBE or intraoperative endoscopy, or the last medical record describing the patient\u2019s condition.<\/jats:p><jats:p>\n            Results This study included 27 polyps in 13 patients. All patients had extraluminal adhesions. None developed symptomatic intussusception, eight patients underwent endoscopic removal at repeat DBE without surgery, two patients underwent removal with intraoperative endoscopy, two patients were observed without polyp removal, and one patient had a polyp removed at repeat DBE and three unreachable polyps remained. Repeat DBE without surgery was able to remove 14 polyps (52%). Polyps \u226715 mm included 11 lesions in eight patients and were observed for a median of 14 months without symptomatic intussusception.<\/jats:p><jats:p>\n            Conclusions The difficult-to-reach polyps may have a low risk of immediate symptomatic intussusception, possibly due to limited bowel mobility by extraluminal adhesions, and the likelihood of reaching them at repeat DBE was substantial. Hence, repeat DBE 1 year later may be proper in such patients with PJS.<\/jats:p>","DOI":"10.1055\/a-2180-9442","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T23:08:20Z","timestamp":1695683300000},"page":"E1110-E1115","source":"Crossref","is-referenced-by-count":1,"title":["Repeat bidirectional double-balloon enteroscopy 1 year later may be proper in Peutz-Jeghers patients with difficult-to-reach polyps"],"prefix":"10.1055","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8939-8147","authenticated-orcid":false,"given":"Yohei","family":"Funayama","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2267-9304","authenticated-orcid":false,"given":"Kunihiko","family":"Oguro","sequence":"additional","affiliation":[{"name":"Department of Medicine, 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