Diagnosis of anorectal tuberculosis by polymerase chain reaction,GeneXpert and histopathology in 1336 samples in 776 anal fistula patients

作     者：Pankaj Garg Ankita Goyal Vipul D Yagnik Sushil Dawka Geetha R Menon 

作者机构：Department of Colorectal SurgeryIndus International HospitalMohali 140507PunjabIndia Department of Colorectal SurgeryGarg Fistula Research InstitutePanchkula 134113HaryanaIndia Department of PathologyGian Sagar Medical College and HospitalPatiala 140506PunjabIndia Department of SurgeryNishtha Surgical Hospital and Research CentrePatan 384265GujaratIndia Department of SurgerySSR Medical CollegeBelle RiveMauritius Department of StatisticsIndian Council of Medical ResearchNew Delhi 110029India 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2021年第13卷第4期

页      面：355-365页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Anal fistula Fistula-in-ano Tuberculosis,Histopathology,Polymerase chainreaction,GeneXpert 

摘      要：BACKGROUND The association of tuberculosis(TB)with anal fistulas can make its treatment quite *** main challenge is timely detection of TB in anal fistulas and its proper *** is little data available on diagnosis and management of TB in anal *** To detect TB in fistula-in-ano patients were analyzed in different methods *** A retrospective analysis of different methods,polymerase chain-reaction(PCR),GeneXpert and histopathology(HPE),utilized to detect tuberculosis in fistula-inano patients,treated between 2014-2020,was *** sampling was done for tissue(fistula tract lining)and pus(when available).The detection rate of various tests to detect TB and prevalence rate of TB in simple vs complex fistulae were *** In 1336 samples(776 patients)tested,TB was detected in 133 samples(122 patients).TB was detected in 52/703(7.4%)samples tested by PCR-tissue,in 77/331(23.2%)samples tested by PCR-pus,3/197(1.5%)samples tested with HPE-tissue and 1/105(0.9%)samples tested by *** detect TB,PCRtissue was significantly better than HPE-tissue(52/703 vs 3/197 respectively)(P=0.0012,significant,Fisher’s exact test)and PCR-pus was significantly better than PCR-tissue(77/331 vs 52/703 respectively)(P0.00001,significant,Fisher’s exact test).TB fistulas were more complex than non-tuberculous fistulas[78/113(69%)vs 278/727(44.3%)respectively](P0.00001,significant,Fisher’s exact test)but the overall healing rate was similar in tuberculous and non-tuberculous fistula groups[90/102(88.2%)vs 518/556(93.2%)respectively](P=0.10,not significant,Fisher’s exact test).CONCLUSION This is the largest study of anorectal TB to be *** detection of TB by polymerase chain-reaction was significantly higher than by histopathology and *** polymerase chain-reaction,pus had a higher detection rate than *** fistulas were more complex than non-tuberculous fistulas but aggressive diagnosis and meticulous treatm