A LIP Abdominal Tuberculosis Classification System for Surgery

Abstract

Tubercular infection can occur in various organs and tissues; however, abdominal tuberculosis is a common form of extrapulmonary tuberculosis after tubercular lymphadenitis. The treatment strategies and surgical indications for different types of abdominal tuberculosis are also not illustrated. This study aimed to create a classification scheme to guide the treatment strategy. The data of abdominal tuberculosis patients admitted to Shaanxi Tuberculosis Hospital from December 2012 to December 2016 were reviewed. All diagnosed abdominal tuberculosis cases were classified into the following 4 types, according to the LIP classification system: lymphatic type (type-L), intestinal type (type-I), peritoneum type (type-P), and mixed type. The differences in medical cure rate, surgical cure rate, postoperative complication rate, and mortality between the patients were compared. The medical cure rate of type-P was the highest of all 4 types (91.7%). The intra-abdominal adhesion of type-I abdominal tuberculosis was milder than those of the other types; hence, laparoscopic surgery can be considered. The incidence of postoperative complications of the mixed type was the highest of the 4 types at 22.7%. The mortality rate of type-L was the highest of the 4 types at 20%. In total, 3 of the 4 deceased mixed patients were found to have L-type abdominal tuberculosis. There were significant differences in the cure rate, complication rate, and mortality rate among the 4 types. The χ2 values were 38.895, 8.253, and 8.601, respectively. The P values were < 0.001, 0.023, and 0.013, respectively. The LIP classification can guide the treatment of abdominal tuberculosis.