Laparoscopic exploration in the diagnosis of tuberculous peritonitis: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

DU Mingnan , ZHANG Xiuzhong ,  ZHANG Yi

Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, P.R.China;

Corresponding?author：

ZHANG Yi, Email: 523981698@qq.com

Keywords：

Laparoscopy; Tuberculous peritonitis; Diagnosis; Meta-analysis

DOI：

10.7507/1672-2531.201907072

Video：

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Objectives To evaluate the clinical value of laparoscopic exploration in the diagnosis of tuberculous peritonitis by meta-analysis.Methods The Cochrane Library, PubMed, Web of Science, WanFang Data, CNKI and VIP databases were electronically searched to collect relevant studies on the diagnostic value of laparoscopic exploration in diagnosing tuberculous peritonitis from January 1^st, 1990 to April 1^st, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. The Rveman 5.3, Meta-DiSc 1.4 and Stata SE15 software were used for statistical analysis and the receiver operating characteristic curve (SROC) was drawn.Results A total of 10 studies involving 1098 patients were included. The results of meta-analysis showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnosis odds ratio and area under the curve of SROC were 0.98 (95%CI 0.96 to 0.98), 0.85 (95%CI 0.78 to 0.91), 4.78 (95%CI 1.98 to 11.54), 0.06 (95%CI 0.03 to 0.12), 111.40 (95%CI 36.55 to 339.58) and 0.971 1, respectively and the Q* was 0.9216.Conclusions The existing evidence shows that laparoscopic exploration has higher sensitivity and specificity in the diagnosis of tuberculous peritonitis. Laparoscopic exploration can be used as a diagnosis and treatment tool for patients with tuberculous peritonitis in case the laboratory test cannot determine the origin. Due to the limited quality and quantity of included studies, the above results should be validated by more studies.

Citation： DU Mingnan, ZHANG Xiuzhong, ZHANG Yi. Laparoscopic exploration in the diagnosis of tuberculous peritonitis: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2020, 20(1): 40-46. doi: 10.7507/1672-2531.201907072 Copy

1.	Peto HM, Pratt RH, Harrington TA, et al. Epidemiology of extrapulmonary tuberculosis in the United States, 1993-2006. Clin Infect Dis, 2009, 49(9): 1350-1357.
2.	Raviglione MC, Snider DE Jr, Kochi A. Global epidemiology of tuberculosis: morbidity and mortality of a worldwide epidemic. JAMA, 1995, 273(3): 220-226.
3.	Cho JK, Choi YM, Lee SS, et al. Clinical features and outcomes of abdominal tuberculosis in southeastern Korea: 12 years of experience. BMC Infect Dis, 2018, 18(1): 699.
4.	Sanai FM, Bzeizi KI. Systematic review: tuberculous peritonitis--presenting features, diagnostic strategies and treatment. Aliment Pharmacol Ther, 2005, 22(8): 685-700.
5.	Marshall JB. Tuberculosis of the gastrointestinal tract and peritoneum. J Clin Tuberc Other Mycobact Dis, 1993, 88(7): 989-999.
6.	Suntur BM, Ku??u F. Pooled analysis of 163 published tuberculous peritonitis cases from Turkey Turk. J Med Sci, 2018, 48(2): 311-317.
7.	Lewis A. Tuberculous peritonitis and laparoscopy. Lancet, 1979, 1(8125): 1084.
8.	Wang WN, Wallack MK, Barnhart S, et al. Tuberculous peritonitis: definitive diagnosis by laparoscopic peritoneal biopsy. Am Surg, 2008, 74(12): 1223-1224.
9.	Wolfe JH, Behn AR, Jackson BT. Tuberculous peritonitis and role of diagnostic laparoscopy. Lancet, 1979, 1(8121): 852-853.
10.	Bhargava DK, Shriniwas, Chopra P, et al. Peritoneal tuberculosis: laparoscopic patterns and its diagnostic accuracy. Am J Gastroenterol, 1992, 87(1): 109-112.
11.	Abdelaal A, Alfkey R, Abdelaziem S, et al. Role of laparoscopic peritoneal biopsy in the diagnosis of peritoneal tuberculosis. A seven-year experience. Chirurgia (Bucur), 2014, 109(3): 330-334.
12.	Hong KD, Lee SI, Moon HY. Comparison between laparoscopy and noninvasive tests for the diagnosis of tuberculous peritonitis. World J Surg, 2011, 35(11): 2369-2375.
13.	Islam J, Clarke D, Thomson SR, et al. A prospective audit of the use of diagnostic laparoscopy to establish the diagnosis of abdominal tuberculosis. Surg Endosc, 2014, 28(6): 1895-1901.
14.	Krishnan P, Vayoth SO, Dhar P, et al. Laparoscopy in suspected abdominal tuberculosis is useful as an early diagnostic method. ANZ J Surg, 2008, 78(11): 987-989.
15.	Sandik?i MU, Colakoglu S, Ergun Y, et al. Presentation and role of peritoneoscopy in the diagnosis of tuberculous peritonitis. J Gastroenterol Hepatol, 1992, 7(3): 298-301.
16.	郝卉杰, 石朝陽, 周川, 等. TP診斷方法比較. 鄭州大學學報(醫學版), 2012, 47(01): 108-110.
17.	黃文生, 王天寶, 陳瑜君, 等. 腹腔鏡探查術對結核性腹膜炎的診斷分析. 中華普外科手術學雜志(電子版), 2011, 5(3): 326-329.
18.	克力木, 牛偉亞, 張成, 等. 結核性腹膜炎腹腔鏡探查直視下診斷價值研究. 中華疝和腹壁外科雜志(電子版), 2010, 4(2): 150-153.
19.	徐惠成, 梁志清, 常青, 等. 腹腔鏡檢查診斷536例結核性腹膜炎分析. 中國內鏡雜志, 2003, 9(7): 19-21.
20.	李淑德, 許國銘. 結核性腹膜炎的診斷與治療. 胃腸病學, 2005, 10(3): 191-192.
21.	Hossain J, al-Aska AK, al Mofleh I. Laparoscopy in tuberculous peritonitis. J R Soc Med, 1992, 85(2): 89-91.
22.	Chow KM, Chow VC, Hung LC, et al. Tuberculous peritonitis-associated mortality is high among patients waiting for the results of mycobacterial cultures of ascitic fluid samples. Clin Infect Dis, 2002, 35(4): 409-413.
23.	費貴軍, 張麗帆, 舒慧君. 結核性腹膜炎實驗室診斷的評估. 中國醫學科學院學報, 2018, 40(4): 534-538.
24.	Wu DC, Averbukh LD, Wu GY. Diagnostic and therapeutic strategies for peritoneal tuberculosis: a Review. J Clin Transl Hepatol, 2019, 7(2): 140-148.
25.	Abayl? B, Gen?dal G. A single-center experience: the diagnostic role of peritoneoscopy in patients with exudative ascites. J Laparoendosc Adv Surg Tech A, 2019, 29(1): 51-54.
26.	Loffer FD, Pent D. Indications, contraindications and complications of laparoscopy. Obstet Gynecol Surv, 1975, 30(7): 407-427.
27.	Mimica M. Usefulness and limitations of laparoscopy in the diagnosis of tuberculous peritonitis. Endoscopy, 1992, 24(6): 588-591.

1. Peto HM, Pratt RH, Harrington TA, et al. Epidemiology of extrapulmonary tuberculosis in the United States, 1993-2006. Clin Infect Dis, 2009, 49(9): 1350-1357.
2. Raviglione MC, Snider DE Jr, Kochi A. Global epidemiology of tuberculosis: morbidity and mortality of a worldwide epidemic. JAMA, 1995, 273(3): 220-226.
3. Cho JK, Choi YM, Lee SS, et al. Clinical features and outcomes of abdominal tuberculosis in southeastern Korea: 12 years of experience. BMC Infect Dis, 2018, 18(1): 699.
4. Sanai FM, Bzeizi KI. Systematic review: tuberculous peritonitis--presenting features, diagnostic strategies and treatment. Aliment Pharmacol Ther, 2005, 22(8): 685-700.
5. Marshall JB. Tuberculosis of the gastrointestinal tract and peritoneum. J Clin Tuberc Other Mycobact Dis, 1993, 88(7): 989-999.
6. Suntur BM, Ku??u F. Pooled analysis of 163 published tuberculous peritonitis cases from Turkey Turk. J Med Sci, 2018, 48(2): 311-317.
7. Lewis A. Tuberculous peritonitis and laparoscopy. Lancet, 1979, 1(8125): 1084.
8. Wang WN, Wallack MK, Barnhart S, et al. Tuberculous peritonitis: definitive diagnosis by laparoscopic peritoneal biopsy. Am Surg, 2008, 74(12): 1223-1224.
9. Wolfe JH, Behn AR, Jackson BT. Tuberculous peritonitis and role of diagnostic laparoscopy. Lancet, 1979, 1(8121): 852-853.
10. Bhargava DK, Shriniwas, Chopra P, et al. Peritoneal tuberculosis: laparoscopic patterns and its diagnostic accuracy. Am J Gastroenterol, 1992, 87(1): 109-112.
11. Abdelaal A, Alfkey R, Abdelaziem S, et al. Role of laparoscopic peritoneal biopsy in the diagnosis of peritoneal tuberculosis. A seven-year experience. Chirurgia (Bucur), 2014, 109(3): 330-334.
12. Hong KD, Lee SI, Moon HY. Comparison between laparoscopy and noninvasive tests for the diagnosis of tuberculous peritonitis. World J Surg, 2011, 35(11): 2369-2375.
13. Islam J, Clarke D, Thomson SR, et al. A prospective audit of the use of diagnostic laparoscopy to establish the diagnosis of abdominal tuberculosis. Surg Endosc, 2014, 28(6): 1895-1901.
14. Krishnan P, Vayoth SO, Dhar P, et al. Laparoscopy in suspected abdominal tuberculosis is useful as an early diagnostic method. ANZ J Surg, 2008, 78(11): 987-989.
15. Sandik?i MU, Colakoglu S, Ergun Y, et al. Presentation and role of peritoneoscopy in the diagnosis of tuberculous peritonitis. J Gastroenterol Hepatol, 1992, 7(3): 298-301.
16. 郝卉杰, 石朝陽, 周川, 等. TP診斷方法比較. 鄭州大學學報(醫學版), 2012, 47(01): 108-110.
17. 黃文生, 王天寶, 陳瑜君, 等. 腹腔鏡探查術對結核性腹膜炎的診斷分析. 中華普外科手術學雜志(電子版), 2011, 5(3): 326-329.
18. 克力木, 牛偉亞, 張成, 等. 結核性腹膜炎腹腔鏡探查直視下診斷價值研究. 中華疝和腹壁外科雜志(電子版), 2010, 4(2): 150-153.
19. 徐惠成, 梁志清, 常青, 等. 腹腔鏡檢查診斷536例結核性腹膜炎分析. 中國內鏡雜志, 2003, 9(7): 19-21.
20. 李淑德, 許國銘. 結核性腹膜炎的診斷與治療. 胃腸病學, 2005, 10(3): 191-192.
21. Hossain J, al-Aska AK, al Mofleh I. Laparoscopy in tuberculous peritonitis. J R Soc Med, 1992, 85(2): 89-91.
22. Chow KM, Chow VC, Hung LC, et al. Tuberculous peritonitis-associated mortality is high among patients waiting for the results of mycobacterial cultures of ascitic fluid samples. Clin Infect Dis, 2002, 35(4): 409-413.
23. 費貴軍, 張麗帆, 舒慧君. 結核性腹膜炎實驗室診斷的評估. 中國醫學科學院學報, 2018, 40(4): 534-538.
24. Wu DC, Averbukh LD, Wu GY. Diagnostic and therapeutic strategies for peritoneal tuberculosis: a Review. J Clin Transl Hepatol, 2019, 7(2): 140-148.
25. Abayl? B, Gen?dal G. A single-center experience: the diagnostic role of peritoneoscopy in patients with exudative ascites. J Laparoendosc Adv Surg Tech A, 2019, 29(1): 51-54.
26. Loffer FD, Pent D. Indications, contraindications and complications of laparoscopy. Obstet Gynecol Surv, 1975, 30(7): 407-427.
27. Mimica M. Usefulness and limitations of laparoscopy in the diagnosis of tuberculous peritonitis. Endoscopy, 1992, 24(6): 588-591.

Chinese Journal of Evidence-Based Medicine

Laparoscopic exploration in the diagnosis of tuberculous peritonitis: a meta-analysis

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