Laparoscopic Nissen fundoplication is more effective in treating patients with GERD-related chronic cough than Stretta radiofrequency

Minerva Chir. 2014 Jun;69(3):121-7. Epub 2014 May 14.

Abstract

Aim: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Catheter Ablation / methods*
  • Chronic Disease
  • Cough / etiology
  • Cough / surgery*
  • Esophageal Sphincter, Lower
  • Female
  • Follow-Up Studies
  • Fundoplication / methods*
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / drug therapy
  • Gastroesophageal Reflux / surgery*
  • Humans
  • Laparoscopy*
  • Male
  • Middle Aged
  • Proton Pump Inhibitors / therapeutic use
  • Quality of Life
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Substances

  • Proton Pump Inhibitors