Long-Term Outcomes of Chronic Cough Reduction after Laparoscopic Nissen Fundoplication-A Single-Center Study.

Natalia Dowgiałło-Gornowicz,Justyna Kacperczyk,Sławomir Saluk,Anna Masiewicz,Paweł Lech,Karolina Osowiecka,Maciej Michalik

doi:10.3390/medicina58010047

Abstract

Background and Objectives: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal diseases. It affects 20% of the adult population and is the third most common cause of chronic cough in adults. This study describes the results of LNF for the relief of GERD-related cough. Materials and Methods: The prospectively collected data on 135 laparoscopic LNF in our department from 2014 to 2018 were reviewed. During consultations, patients were asked about the frequency of symptoms using the GERD Impact Scale (GERD-IS), their satisfaction and recommendation to others, and their general condition after the procedure. Results: We analyzed 23 of 111 patients (20.7%) reporting chronic cough. The mean age was 47 years (range 27–76 years, ±13.9 years) and the mean follow-up time was 48.3 months (range 22.6–76.3 ± 18.05 months). Most patients reported relief from cough after the surgery (78.3%, p < 0.001). Five patients (22%) reported the recurrence of symptoms after a mean of 10.8 months (6–18 months). Seventeen patients (74%) would undergo the surgery again and 18 patients (78%) would recommend the surgery to their relatives. There was a statistically significant improvement in all symptoms from the GERD-IS (p < 0.05). Conclusions: LNF may play an important role in the management of GERD patients with extraesophageal symptoms. After LNF, most of the operated patients reported complete resolution of chronic cough and would recommend the procedure to their relatives.

Highlights

Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal disease
It affects 20% of the adult population [1]. It is a clinical manifestation of irritation or damage of esophageal mucosa. This is a result of abnormal reflux of gastric contents into the esophagus, caused by insufficient tension of the lower esophageal sphincter (LES) or hiatal hernia [2]
GERD can manifest as extraesophageal symptoms, such as chronic cough, asthma, sore throat, laryngitis, and hoarseness [4]

Summary

Introduction

Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal disease It affects 20% of the adult population [1]. GERD can manifest as extraesophageal symptoms, such as chronic cough, asthma, sore throat, laryngitis, and hoarseness [4]. These symptoms may occur with or without typical symptoms of GERD. Patients with chronic cough report fatigue, anxiety, and depression much more often [7]. This reduces the quality of life of patients [8,9].

Surgical Technique

Statistical Analysis

Results

Discussion

Conclusions