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首页> 外文期刊>Surgical Endoscopy >A prospective audit of the use of diagnostic laparoscopy to establish the diagnosis of abdominal tuberculosis
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A prospective audit of the use of diagnostic laparoscopy to establish the diagnosis of abdominal tuberculosis

机译：使用诊断性腹腔镜检查对腹部结核病进行诊断的前瞻性审核

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Background: The incidence of abdominal tuberculosis is much higher in an HIV-positive cohort. The use of laparoscopy in the diagnostic work-up of suspected abdominal tuberculosis is underutilized and its use and efficacy in the context of HIV co-infection has never been examined. Methods: A prospective clinical audit of the use of diagnostic laparoscopy was conducted in patients with clinically suspected abdominal tuberculosis but histologically or microbiologically unconfirmed tuberculosis at any site. Results: From January 2008 to June 2010, 81 patients underwent diagnostic laparoscopy; 34 were male and 47 were female, with a mean age of 33 years, and 77 % were HIV-positive. Fifty-five patients (68 %) had positive histology or culture for tuberculosis. In 15 patients (19 %), histology revealed non-specific inflammation, no pathology was found in one patient, and no specimen was taken from one patient. Eighty percent of peritoneal deposits and 77 % of lymph nodes were positive for tuberculosis, whereas 35 % of ascitic fluid cultures were positive. In nine patients (11 %) an alternative diagnosis was found; nine patients (11 %) had conversion to laparotomy. There was no procedure-related death. Nine patients (11 %) died during the 2-month follow-up period. Conclusions: Diagnostic laparoscopy avoids the morbidity and mortality of laparotomy in chronically ill patients, and reduces the rate of misdiagnosis of other abdominal conditions and unnecessary long-term therapy. Diagnostic laparoscopy and tissue sampling is a viable and reliable strategy in patients with suspected abdominal tuberculosis.
机译：背景：在艾滋病毒阳性人群中，腹部结核的发病率更高。腹腔镜检查在可疑腹部结核的诊断检查中的使用未得到充分利用，并且从未检查过其在HIV合并感染中的使用和功效。方法：对临床怀疑为腹腔结核但在任何组织学或微生物学上未确诊的结核病患者进行了诊断性腹腔镜检查的前瞻性临床审计。结果：2008年1月至2010年6月，有81例患者接受了诊断性腹腔镜检查。男性34例，女性47例，平均年龄33岁，而HIV阳性率为77％。五十五名患者（68％）的组织学或结核病培养呈阳性。在15例患者（占19％）中，组织学显示非特异性炎症，一名患者未发现病理学，且未从一名患者中获取标本。 80％的腹膜沉积物和77％的淋巴结结核是阳性，而35％的腹水培养是阳性的。在9名患者中（11％），发现了另一种诊断方法。 9名患者（11％）转换为剖腹手术。没有与手术相关的死亡。在2个月的随访期内，有9名患者（11％）死亡。结论：诊断性腹腔镜检查避免了慢性病患者剖腹手术的发病率和死亡率，并减少了其他腹部疾病的误诊率和不必要的长期治疗。诊断性腹腔镜检查和组织采样是怀疑腹部结核病患者可行且可靠的策略。

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