A strong link exists between gastroesophageal reflux disease (GERD) and airway disease. We sought to determine the long-term results of laparoscopic antireflux surgery (LARS) for multiple airway symptoms of GERD.
Methods Between 12/15/1993 and 12/21/2002, 750 patients underwent LARS at the University of Washington. Of these patients, 230 (31%) experienced cough, hoarseness, or wheezing more than once per week and had failed medical management. We attempted to contact each patient and succeeded in 136 patients (59%). At a median follow-up of 53 months (range 19–110 mo) we determined frequency and severity of airway symptoms (cough, hoarseness, wheezing, sore throat, dyspnea), esophageal symptoms (heartburn, regurgitation, dysphagia), anti-acid medication usage, happiness with surgery, and rating of operative treatment.
Results Airway symptoms improved in the majority of patients (Table). Typical GERD symptoms (heartburn, regurgitation) improved in 87–93% of patients. Preoperatively, almost all patients (98%) used prescription medical therapy. Forty-five patients (33%) continue to use daily prescription medication. The majority of patients (88%) were happy with the operative treatment, which was rated excellent by 78 patients (57%) and good by 33 patients (24%).
Conclusions LARS provides long-term relief of airway symptoms in over two-thirds of patients with associated abnormal GERD, and in 90% of patients with typical symptoms of GERD. LARS should be considered for patients with proven GERD and cough, hoarseness, or wheezing, especially when medical management has failed.