Laparoscopic fundoplication for gastroesophageal reflux disease-related cough: a report of 70 cases

Abstract

To investigate the efficacy and safety of laparoscopic fundoplication for gastroesophageal reflux disease (GERD)-related cough. Retrospective review of 70 patients with GERD-related cough who received laparoscopic fundoplication in GERD Department of The Second Artillery General Hospital during June 2008 to June 2013 was carried out. GERD-related symptoms (reflux, heartburn, cough, expectoration, globus sensation and hoarseness) before and after surgery were compared through questionnaire, and the symptom remission rate (preoperative symptom score - postoperative symptom score)/preoperative symptom score×100%) was calculated. Complication morbidity and satisfaction degree of patients were investigated. The GERD-related symptom scores of regurgitation, heartburn, cough, expectoration, globus sensation and hoarseness all significantly decreased (all P<0.01) after the anti-reflux laparoscopic fundoplication, with the corresponding symptom remission rates as (79.4±23.2)%, (82.0±21.5)%, (72.2±28.5)%, (62.6±28.9)%, (76.1±31.5)% and (70.8±39.3)% respectively. No major complication and death occurred. Five cases (7.1%) had pneumoperitoneum-related chest or neck subcutaneous emphysema, 17 cases (24.3% ) had various degree of early and late dysphagia, 6 cases (8.6%) had increased flatus and 2 cases had bloating after surgery. All the complications could be cured by appropriate treatment. Among all the patients, 16 cases (15.7%) felt very satisfied, 37 cases (52.9%) felt satisfied, 11 cases (15.7%) felt acceptable, 4 cases (5.7%) felt unsatisfied and 2 cases felt very unsatisfied with the surgery. Laparoscopic fundoplication is safe and effective for GERD-related cough, with quite high satisfaction degree form patients.