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Effectiveness of Antireflux Surgery for the Cure of Chronic Cough Associated with Gastroesophageal Reflux Disease

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Abstract

Background

The effectiveness of surgical therapy for chronic cough secondary to gastroesophageal reflux disease remains controversial. The purpose of this study was to assess the efficacy of surgery and to identify the preoperative clinical profile that could predict the positive effects of treatment on chronic cough.

Study Design

Of 299 patients who underwent antireflux surgery between 1995 and 2010, 67 patients were affected by chronic cough and typical symptoms. In addition, 83 patients with typical symptoms were selected to form the control group, according to the parameters of age, sex, and the period of surgical activity. Preoperatively, all patients underwent a workup, including symptom assessment, barium swallow, upper gastrointestinal endoscopy, esophageal manometry, and 24-h pH recording or intraluminal impedance/pH monitoring in the absence of esophagitis. Patients with chronic cough also were administered a high-resolution computed tomography scan of the chest, a methacholine challenge test, and spirometry. Surgery was performed on patients positive for gastroesophageal reflux disease and negative for pulmonary diseases. The patients were followed up for a median of 84 months after surgery.

Results

No significant differences in preoperative reflux symptoms or esophagitis were found between the two groups. After surgery, chronic cough was absent in 57 (85 %) patients. Of the ten patients who still reported chronic cough, reflux symptoms relapsed in five, two of whom developed esophagitis. In the other five patients, typical symptoms were absent, and their chronic cough had improved but had not disappeared.

Conclusions

Surgery is effective for the treatment of chronic cough secondary to gastroesophageal reflux disease, particularly if associated with severe and long-standing typical symptoms.

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Conflict of interest

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Author information

Authors and Affiliations

  1. Division of Thoracic Surgery, Center for the Study and Therapy of Diseases of the Esophagus, Alma Mater Studiorum - University of Bologna, Via G. Massarenti 9, 40138, Bologna, Italy

    Marialuisa Lugaresi, Fabio Baldi & Sandro Mattioli

  2. GVM Care and Research, Cotignola, Italy

    Marialuisa Lugaresi, Fabio Baldi & Sandro Mattioli

  3. Ph.D. Course in Pneumo-Cardio-Thoracic Sciences, XXIII Cycle, Alma Mater Studiorum - University of Bologna, Bologna, Italy

    Beatrice Aramini

  4. Thoracic Surgery Unit, University of Perugia, Perugia, Italy

    Niccolò Daddi

Authors
  1. Marialuisa Lugaresi
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  2. Beatrice Aramini
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  3. Niccolò Daddi
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  4. Fabio Baldi
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  5. Sandro Mattioli
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Corresponding author

Correspondence to Sandro Mattioli.

Additional information

ClinicalTrials.gov ID NCT01899183; https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0004BDN&selectaction=View&uid=U0000GED&ts=3&cx=-773yj2.

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Lugaresi, M., Aramini, B., Daddi, N. et al. Effectiveness of Antireflux Surgery for the Cure of Chronic Cough Associated with Gastroesophageal Reflux Disease. World J Surg 39, 208–215 (2015). https://doi.org/10.1007/s00268-014-2769-7

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  • DOI: https://doi.org/10.1007/s00268-014-2769-7

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