Effectivenes of Antireflux Surgery(Fundoplication) for the cure of Chronic Cough with or without GERD Symptoms.

Background: The outcome of surgical therapy for atypical extra-esophageal symptoms allegedly secondary to GERD is controversial. Aim of this study was to assess the results of antirefl ux surgery in patients affected by 1) typical, 2) typical atypical, (chronic cough), in whom a dedicated preoperative work up was performed. Methods: Between 1995 and 2010, 151 patients with GERD-related typical and/or atypical symptoms were submitted to antirefl ux surgery. One hundred percent preoperatively underwent semi-quantitative evaluation of typical/atypical symptoms, chronic cough and esophagitis, barium swallow, endoscopy and histology and esophageal manometry (24 h pH-recording or intraluminal impedance/pH monitoring system in the absence of gross esophagitis). In addition, patients with chronic cough underwent chest HRCT scan, methacholine challenge test and spirometry. Surgery was performed exclusively on patients positive for GERD and negative for pulmonary diseases. Preoperative tests for GERD were repeated at follow-up. Results: Patients were ordered into two groups: A) 83 patients with typical symptoms only, B) 68 patients with typical symptoms and chronic cough. In both groups, antirefl ux surgery demonstrated to signifi cantly improve typical symptoms. The global score for outcome showed no signifi cant differences between group A and B. In group B, antirefl ux surgery signifi cantly improved chronic cough as well. Discussion: The preoperative work up was highly effective in selecting patients for antirefl ux surgery which achieved very satisfactory results in the treatment of GERD and GERD-related chronic cough. Disclosure: All authors have declared no confl icts of interest.