Background: Extraesophageal syndromes are more difficult to identify and treat than the usual esophageal symptoms

Abstract

Objective The current study explores the efficacy of laparoscopic Nissen fundoplication(LNF)on gastroesophageal reflux disease(GERD)-related respiratory symptoms(RSs). Methods From April 2010 to April 2011, LNF was performed on 130 patients(85 men and 45 women)in Beijing Aerospace General Hospital, the see ond Artillery General Hospital of Chinese People′s Liberation Army and the First Affiliated Aospital of Zhengzhou University, with GERD-related RSs according to underlying esophageal motility.A questionnaire form ranging from 0 to 5 was the basic requirement for recording pretreatment and posttreatment and for making detailed evaluation of the symptoms.All scores of GERD-related RSs, such as heartburn, regurgitation, coughing, breathe holding, wheezing, shortness of breath, and choking, significantly decreased at the 12th month.during a 12-month follow-up observation. Results All the patients who participated in the current study were adults and elders aged 22 to 80 years with a mean age of 50 years.The median length of stay was 4.5 days with a range of 2 to 8 days.The median score of heartburn, regurgitation, coughing, wheezing, shortness of breath, choking, and chest pain decreased from(4.87±1.74), (5.02±1.79), (7.09±1.81), (7.45±1.70), (5.80±2.10), (5.88±2.25), (5.0±1.80) to (1.60±2.31), (0.64±1.50), (2.87±2.91), (2.50±2.87), (1.80±2.07), (1.37±2.01), and (1.58±2.74)(P<0.01), respectively.A total of 130 patients had various relieved symptom scores, 10 patients(7.7%)had different scale recurrence of symptoms after laparoscopic fundoplication treatment, and 7 patients had to retreat to omeprazole as an auxiliary medical therapy.Three other patients rejected any therapy, and no deaths occurred.A single patient converted from laparoscopic surgery to open surgery.Several short-term symptoms included retrosternal uneasiness or pain(n=42; 32.3%), dysphagia(n=12; 9.2%), abdominal distension(n=21; 16.2%), and diarrhea(n=23; 11.6%). Early dysphagia lasting<6 weeks was common, and 16 patients(12.3%)underwent an early esophagogastroduodenoscopy or contrast swallow.Five patients(1.9%)who had prolonged dysphagia during the 6-month clinical review required esophageal dilatation, and the outcomes were successful. Conclusion LNF can be an effective means for treating RSs in patients with GERD. Key words: Gastroesophageal reflux; Fundoplication; Laparoscopy; Respiratory symptoms