Laparoscopic surgery for the diagnosis of abdominal effusion in the modern era of imaging – a retrospective study in a low-to-middle-income country

Annals of Medicine and Surgery - Tập 85 Số 3 - Trang 422-426
Dang Quoc Ai1,2, Ha Thi Thuy Hang3, Trần Quế Sơn4,2
1Department of General Surgery, E Hospital
4Department of General Surgery, Bach Mai Hospital, Hanoi, Vietnam

Tóm tắt

Introduction:

Intraperitoneal ascites is a consequence or combination of many different underlying diseases. Laparoscopy with peritoneal biopsy is a tool for rapid and accurate diagnosis.

 Methods:

We retrospectively identified patients who could not be diagnosed by clinical examination, laboratory investigations, and imaging tests.

 Results:

A total of 103 (55 male and 48 female) patients were selected. The median age of the study group was 54 years (range 38–64 years). Typical clinical symptoms included fever (58.2%), abdominal pain (56.3%), and digestive disorders (62.1%). Fever and digestive disorders were higher in the peritoneal tuberculosis (TB) group than in the metastatic cancer group [(62.1% vs. 12.5%, P=0.009) and (66.3% vs. 12.5%, P=0.004)]. Abdominal pain was more common in the metastatic cancer group than in the other groups (100% vs. 55.8%, P=0.020). Patients in the TB and chronic inflammation groups had lower red blood cell counts and blood albumin (41 vs. 42, P=0.039) than those in the metastatic cancer group, respectively. The rate of intestinal wall thickening on ultrasound and peritoneal thickening on computed tomography was higher in the cancer group than in the benign group (87.5% vs. 7.4%, P=0.000) (75% vs. 23.2%, P=0.005), respectively. There was no difference in the median peritoneal fluid volume between the two groups (390 vs. 340, P=0.058). Pathological results showed 88.3%, 7.8%, and 3.9% of peritoneal TB, metastatic cancer, and chronic inflammatory lesions, respectively. The median hospital stay did not differ between the two groups (4 vs. 3 days, P=0.051). Both groups of patients had no morbidity or mortality.

 Conclusion:

Unidentified ascites and peritonitis must be difficult for making diagnose by conventional methods. Laparoscopy might be supportive of making a rapid diagnosis and starting early treatment.

Từ khóa


Tài liệu tham khảo

Amarapurkar, 2013, Diagnostic laparoscopy in the era of modern imaging – retrospective analysis from a single center, Indian J Gastroenterol, 32, 302, 10.1007/s12664-013-0338-x

Huang, 2018, Comparison between laparoscopy and laboratory tests for the diagnosis of tuberculous peritonitis, Turk J Med Sci, 48, 711, 10.3906/sag-1512-147

Sanai, 2005, Systematic review: tuberculous peritonitis – presenting features, diagnostic strategies and treatment, Aliment Pharmacol Ther, 22, 685, 10.1111/j.1365-2036.2005.02645.x

Oey, 2016, The diagnostic work-up in patients with ascites: current guidelines and future prospects, Neth J Med, 74, 330

Purbadi, 2021, Peritoneal tuberculosis mimicking advanced ovarian cancer case report: laparoscopy as diagnostic modality, Int J Surg Case Rep, 88, 106495, 10.1016/j.ijscr.2021.106495

Yamada, 2020, Tuberculous peritonitis; The effectiveness of diagnostic laparoscopy and the perioperative infectious prevention: a case report, Int J Surg Case Rep, 72, 326, 10.1016/j.ijscr.2020.06.046

Muroni, 2015, Abdominal tuberculosis: utility of laparoscopy in the correct diagnosis, J Gastrointest Surg, 19, 981, 10.1007/s11605-015-2753-z

Milingos, 2007, Laparoscopy in the evaluation of women with unexplained ascites: an invaluable diagnostic tool, J Minim Invasive Gynecol, 14, 43, 10.1016/j.jmig.2006.06.020

Han, 2008, Diagnostic laparoscopy in ascites of unknown origin: Chang Gung Memorial Hospital 20-year experience, Chang Gung Med J, 31, 378

Wang, 2011, Diagnostic value of mini-laparoscopy in patients with abdominal neoplasm, Chin J Cancer Res, 23, 214, 10.1007/s11670-011-0214-0

Garofalo, 2009, Laparoscopy in the management of peritoneal carcinomatosis, Cancer J, 15, 190, 10.1097/PPO.0b013e3181a58e93

Krishnan, 2008, Laparoscopy in suspected abdominal tuberculosis is useful as an early diagnostic method, ANZ J Surg, 78, 987, 10.1111/j.1445-2197.2008.04717.x

Parums, 2021, Editorial: Updates from the World Health Organization (WHO) on global treatment recommendations for drug-susceptible and multidrug-resistant tuberculosis, Med Sci Monit, 27, e934292, 10.12659/MSM.934292

Nguyen, 2021, Decline of tuberculosis burden in Vietnam measured by consecutive national surveys, 2007–2017, Emerg Infect Dis, 27, 872, 10.3201/eid2703.204253

Mathew, 2021, STROCSS 2021: strengthening the reporting of cohort, cross-sectional and case-control studies in surgery, Int J Surg, 96, 10616516, 10.1016/j.ijsu.2021.106165

Van Slambrouck, 2021, A case report of peritoneal tuberculosis diagnosed by laparoscopy in a low prevalence setting, Acta Chir Belg, 121, 269, 10.1080/00015458.2019.1693152

Volpi, 2004, Genital and peritoneal tuberculosis: potential role of laparoscopy in diagnosis and management, J Am Assoc Gynecol Laparosc, 11, 269, 10.1016/S1074-3804(05)60213-7

Dao, 2022, A geospatial platform to support visualization, analysis, and prediction of tuberculosis notification in space and time, Front Public Health, 10, 973362, 10.3389/fpubh.2022.973362

Mazurek, 2010, Updated guidelines for using Interferon Gamma Release Assays to detect Mycobacterium tuberculosis infection - United States, 2010, MMWR Recomm Rep, 59, 1

Shen, 2022, Effect of adjusted cut-offs of interferon-gamma release assays on diagnosis of tuberculosis in patients with fever of unknown origin, J Clin Tuberc Other Mycobact Dis, 26, 100290, 10.1016/j.jctube.2021.100290

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Thông tin xuất bản

Annals of Medicine and Surgery

Tập 85 Số 3

422-426

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