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61 LONG-TERM OUTCOMES OF LAPAROSCOPIC ANTIREFLUX SURGERY FOR AIRWAY MANIFESTATIONS OF GASTROESOPHAGEAL REFLUX DISEASE
  1. J. E. Houghland,
  2. E. Quiroga,
  3. M. Cahill,
  4. C. A. Pellegrini,
  5. B. K. Oelschlager
  1. Seattle, WA.

Abstract

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 prescriptive 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.

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