Liang W T, Wu J M, Hu Z W, Wang Z G, Zhu G C, Zhang C
Department of Thoracic Cardiovascular Surgery Xuanwu Hospital, Capital Medical University No. 45 Changchun Street, Xicheng District, Beijing, P.R. China -
Minerva Chir. 2014 Jun;69(3):121-7. Epub 2014 May 14.
Chronic cough is the most common extra-esophageal manifestation of gastroesophageal reflux disease (GERD). This study aimed to retrospectively analyze outcomes in patients with GERD-related cough following laparoscopic Nissen fundoplication (LNF) and Stretta radiofrequency (RF) respectively.
Medical charts of 83 patients with GERD-related cough that underwent LNF or Stretta RF between 2007 and 2012 were retrieved. Symptom scores (heartburn, regurgitation and cough) and proton pump inhibitors (PPIs) usages were evaluated.
A total of 83 patients with GERD-related cough underwent LNF (N.=35) and Stretta RF (N.=48), and were followed up 36.78 ± 16.12 months (range 13-55 months). During the follow-up, the post-treatment scores were statistically lower as compared with the pre-treatment scores in both groups, while the cough improvement after Stretta was significantly lower than that after LNF (P<0.001). Besides, 27 (77.1%) patients achieved complete PPI therapy independence after LNF, comparing with 27 (65.1%) after Stretta (P<0.05). No significant differences in post-treatment complications were observed except for the abdominal distention.
Even though laparoscopic Nissen fundoplication and Stretta are capable of controlling GERD-related cough effectively and safely in selected patients, laparoscopic Nissen fundoplication could improve more in symptoms and PPI elimination.
慢性咳嗽是胃食管反流病(GERD)最常见的食管外表现。本研究旨在分别回顾性分析腹腔镜nissen胃底折叠术(LNF)和Stretta射频消融术(RF)治疗GERD相关性咳嗽患者的疗效。
检索2007年至2012年间83例接受LNF或Stretta RF治疗的GERD相关性咳嗽患者的病历。评估症状评分(烧心、反流和咳嗽)和质子泵抑制剂(PPI)的使用情况。
共有83例GERD相关性咳嗽患者接受了LNF(n = 35)和Stretta RF(n = 48)治疗,并随访36.78±16.12个月(范围13 - 55个月)。随访期间,两组治疗后的评分均显著低于治疗前,而Stretta术后咳嗽改善程度显著低于LNF术后(P < 0.001)。此外,LNF术后27例(77.1%)患者实现了完全停用PPI治疗,而Stretta术后为27例(65.1%)(P < 0.05)。除腹胀外,治疗后并发症无显著差异。
尽管腹腔镜nissen胃底折叠术和Stretta射频消融术能够在部分患者中有效且安全地控制GERD相关性咳嗽,但腹腔镜nissen胃底折叠术在症状改善和停用PPI方面效果更佳。