Risk factors analysis for small bowel polyp recurrence in children with Peutz-Jeghers syndrome: A retrospective cohort study.

OBJECTIVES

Peutz-Jeghers syndrome (PJS) is a genetic disorder characterized by gastrointestinal polyps, mucocutaneous pigmentation, and increased malignancy risk. In pediatric patients, recurrent complications such as intussusception often result in frequent surgeries. This study aimed to identify clinical risk factors for small bowel polyp recurrence in children with PJS.

METHODS

We retrospectively analyzed 64 pediatric PJS patients who had at least two follow-up visits. Clinical data, including demographics, clinical features, and endoscopic findings, were collected. The primary outcome was recurrence of small bowel polyps, defined as polyps with a maximum diameter ≥ 15 mm. Kaplan-Meier survival curves and Cox proportional hazards models were used to assess risk factors.

RESULTS

The cohort's median age was 8.0 years, with a male-to-female ratio of 1.78:1. The median time to recurrence of small bowel polyps was 36.4 months. The estimated recurrence rates at 12, 24, and 36 months were 19.8% (95% confidence interval [CI]: 9.0%-29.3%), 33.2% (95%CI: 18.9%-44.9%), and 46.2% (95%CI: 28.0%-59.7%), respectively. Patients with a higher number of polyps (≥10) and larger polyp size (≥2 cm in diameter) exhibited a more rapid recurrence. Multivariate Cox regression analysis identified that the number of small bowel polyps (≥10) (hazard ratio [HR] 5.61, 95%CI: 1.65-19.09) and polyp size (HR 1.20, 95%CI: 1.01-1.42) were significantly associated with an increased risk of recurrence.

CONCLUSIONS

Greater polyp number (≥10) and larger polyp diameter are independent risk factors for recurrence. Early screening for polyps is essential, even in asymptomatic PJS patients.