Abstract：
BACKGROUND: Gastrointestinal strictures impact clinical presentation in abdominal tuberculosis and are associated with significant morbidity.
OBJECTIVE: To conduct a systematic review of the prevalence of stricturing disease in abdominal and gastrointestinal tuberculosis and response to antitubercular therapy (ATT).
METHODS: We searched Pubmed and Embase on 13th January 2022, for papers reporting on the frequency and outcomes of stricturing gastrointestinal tuberculosis. The data were extracted, and pooled prevalence of stricturing disease was estimated in abdominal tuberculosis and gastrointestinal (intestinal) tuberculosis. The pooled clinical response and stricture resolution (endoscopic or radiologic) rates were also estimated. Publication bias was assessed using the Funnel plot and Egger test. The risk of bias assessment was done using a modified Newcastle Ottawa Scale.
RESULTS: Thirty-three studies reporting about 1969 patients were included. The pooled prevalence of intestinal strictures in abdominal tuberculosis and gastrointestinal TB was 0.12 (95%CI 0.07-0.20, I2 = 89%) and 0.27 (95% CI 0.21-0.33, I2 = 85%), respectively. The pooled clinical response of stricturing gastrointestinal tuberculosis to antitubercular therapy was 0.77 (95%CI 0.65-0.86, I2 = 74%). The pooled stricture response rate (endoscopic or radiological) was 0.66 (95%CI 0.40-0.85, I2 = 91%). The pooled rate of need for surgical intervention was 0.21 (95%CI 0.13-0.32, I2 = 70%), while endoscopic dilatation was 0.14 (95%CI 0.09-0.21, I2 = 0%).
CONCLUSIONS: Stricturing gastrointestinal tuberculosis occurs in around a quarter of patients with gastrointestinal tuberculosis, and around two-thirds of patients have a clinical response with antitubercular therapy. A subset of patients may need endoscopic or surgical intervention. The estimates for the pooled prevalence of stricturing disease and response to ATT had significant heterogeneity.
OBJECTIVE: To conduct a systematic review of the prevalence of stricturing disease in abdominal and gastrointestinal tuberculosis and response to antitubercular therapy (ATT).
METHODS: We searched Pubmed and Embase on 13th January 2022, for papers reporting on the frequency and outcomes of stricturing gastrointestinal tuberculosis. The data were extracted, and pooled prevalence of stricturing disease was estimated in abdominal tuberculosis and gastrointestinal (intestinal) tuberculosis. The pooled clinical response and stricture resolution (endoscopic or radiologic) rates were also estimated. Publication bias was assessed using the Funnel plot and Egger test. The risk of bias assessment was done using a modified Newcastle Ottawa Scale.
RESULTS: Thirty-three studies reporting about 1969 patients were included. The pooled prevalence of intestinal strictures in abdominal tuberculosis and gastrointestinal TB was 0.12 (95%CI 0.07-0.20, I2 = 89%) and 0.27 (95% CI 0.21-0.33, I2 = 85%), respectively. The pooled clinical response of stricturing gastrointestinal tuberculosis to antitubercular therapy was 0.77 (95%CI 0.65-0.86, I2 = 74%). The pooled stricture response rate (endoscopic or radiological) was 0.66 (95%CI 0.40-0.85, I2 = 91%). The pooled rate of need for surgical intervention was 0.21 (95%CI 0.13-0.32, I2 = 70%), while endoscopic dilatation was 0.14 (95%CI 0.09-0.21, I2 = 0%).
CONCLUSIONS: Stricturing gastrointestinal tuberculosis occurs in around a quarter of patients with gastrointestinal tuberculosis, and around two-thirds of patients have a clinical response with antitubercular therapy. A subset of patients may need endoscopic or surgical intervention. The estimates for the pooled prevalence of stricturing disease and response to ATT had significant heterogeneity.
摘要：
背景：胃肠道狭窄影响腹部结核的临床表现，并与显著的发病率相关。
目的：对腹部和胃肠道结核狭窄性疾病的患病率以及对抗结核治疗（ATT）的反应进行系统评价。
方法：我们在2022年1月13日搜索了Pubmed和Embase，以获取有关狭窄性胃肠结核的频率和结果的论文。数据被提取出来,在腹部结核和胃肠(肠)结核中,狭窄疾病的合并患病率得到了估计.还估计了合并的临床反应和狭窄消退率（内窥镜或放射学）。使用漏斗图和Egger检验评估出版偏倚。使用改良的纽卡斯尔渥太华量表进行偏倚风险评估。
结果：纳入了关于1969名患者的33项研究。腹部结核和胃肠道结核合并肠狭窄的患病率分别为0.12(95CI0.07-0.20,I2=89%)和0.27(95%CI0.21-0.33,I2=85%),分别。狭窄性胃肠结核对抗结核治疗的合并临床反应为0.77（95CI0.65-0.86，I2=74％）。合并狭窄反应率（内窥镜或放射学）为0.66（95CI0.40-0.85，I2=91％）。合并的手术干预需求率为0.21（95CI0.13-0.32，I2=70％），而内镜下扩张为0.14（95CI0.09-0.21，I2=0%）。
结论：约1/4的胃肠结核患者发生有狭窄性胃肠结核，大约三分之二的患者对抗结核治疗有临床反应。一部分患者可能需要内窥镜或手术干预。狭窄疾病的合并患病率和对ATT的反应的估计具有显着的异质性。
目的：对腹部和胃肠道结核狭窄性疾病的患病率以及对抗结核治疗（ATT）的反应进行系统评价。
方法：我们在2022年1月13日搜索了Pubmed和Embase，以获取有关狭窄性胃肠结核的频率和结果的论文。
结果：纳入了关于1969名患者的33项研究。
结论：约1/4的胃肠结核患者发生有狭窄性胃肠结核，
