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DO PATIENTS WITH CHRONIC COUGH BENEFIT FROM LAPAROSCOPIC ANTI-REFLUX SURGERY?
Adam S. Weltz*, Hamid R. Zahiri, Udai Sibia, Nan Wu, Macey Yates, Olmos Holmatova, Timothy R. Turner, Adrian Park
General Surgery, Anne Arundel Medical Center, Annapolis, MD
Introduction
Although the benefits of surgery are well documented in patients with typical symptoms of Gastroesophageal Reflux Disease (GERD), far less is known about the impact of anti reflux surgery for atypical GERD symptoms. Our study aimed to examine operative and quality of life (QOL) outcomes after laparoscopic anti-reflux surgery (LARS) for patients presenting with chronic cough.
Methods
Retrospective review of patients who underwent LARS for pathologic reflux between February 2012 and April 2016 was conducted. Patient QOL was analyzed up to 3 years post-surgery using three validated surveys: Reflux symptom index (RSI), Laryngopharyngeal reflux QOL (LPR-QOL) and swallowing QOL (SWAL)
Results
One hundred patients (23 Male, 77 Female) with chronic cough as their primary reflux symptom had mean age (61.0 years), BMI (28.5 kg/m2) and ASA score (2.3). Mean DeMeester score was 37.0. The non-wound related complication rate was 5.0%. There were no wound related complications. Patients reported significant improvements in their chronic cough at the one year follow up. Subset analysis showed persistence of benefit after 3 years as reflected by the RSI, LPR and SWAL surveys. Seventy percent of patients had complete resolution of their chronic cough and seventy-nine percent of patients reported independence from anti-reflux medications at 3 year follow up.
Conclusions
With appropriate selection, patients with atypical symptoms of GERD such as chronic cough garner significant benefits in QOL after LARS, with minimal operative or long-term morbidity.
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