Effectiveness of antireflux surgery (fundoplication) for the care of chronic cough ± associated with GOR symptoms

Objectives The outcome of surgical therapy for atypical extra-oesophageal symptoms allegedly secondary to GORD is controversial. Aim of this study was to assess the results of antireflux surgery in patients affected by 1) typical, 2) typical + atypical, (chronic cough), in whom a dedicated preoperative work up was performed. Methods Between 1995-2010, 151 patients with GORD-related typical andtor atypical symptoms were submitted to antireflux surgery. 100% preoperatively underwent semi-quantitative evaluation of typical/atypical symptoms, chronic cough and oesophagitis, barium swallow, endoscopy and histology and oesophageal manometry, (24 hour pH-recording or intraluminal impedance/pH monitoring system in the absence of gross oesophagitis). In addition, patients with chronic cough underwent chest HRCT scan, methacholine challenge test and spirometry. Surgery was performed exclusively on patients positive for GORD and negative for pulmonary diseases. Preoperative tests for GORD 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. See table for preoperative clinical and instrumental assessment, type of surgery, morbidity, mortality, follow up and outcomes. In both groups, antireflux surgery demonstrated to significantly improve typical symptoms. The global score for outcome showed no significant differences between group A and B. In group B. antireflux surgery significantly improved chronic cough as well. Conclusions The preoperative work up was highly effective in selecting patients for antireflux surgery which achieved very satisfactory results in the treatment of GORD and GORD-related chronic cough. Disclosure: All authors have declared no conflicts of interest.