Central Surgical AssociationEfficacy of laparoscopic fundoplication in controlling pulmonary symptoms associated with gastroesophageal reflux disease
Section snippets
Materials and methods
From June 1999 to March 2002, 155 patients undergoing LF enrolled in our study. Seventy-four (46%) of these patients reported chronic pulmonary symptoms that were mild in most cases, and they are the cohort discussed in this report. There were 28 men and 46 women. Median age was 52.5 years (range, 29-84 years). All patients were referred for operation primarily complaining of typical symptoms of GERD such as heartburn, regurgitation, and water brash. All 74 patients were found to have pulmonary
Surgical outcomes
All 74 patients underwent Nissen fundoplication. There were no partial fundoplications in the series and no perioperative deaths. Morbidity occurred in 5 (7%) of patients and included pneumothorax (n = 1), atrial fibrillation (n = 1), pneumonia (n = 1), superficial wound infection (n = 1), and pleural effusion (n = 1). Median length of stay was 2 (range, 1-6) days. Median time to return to normal activity was 2.25 (range, 1-8) weeks. Median follow-up was 12 (range, 1-36) months.
Symptoms
Typical symptoms
Discussion
Although several investigators have reported on a link between pulmonary diseases and GERD, it is rare to see patients with chronic pulmonary symptoms undergoing diagnostic evaluation for GERD in clinical practice. In part this might be explained by the different perspectives and training of pulmonary and gastrointestinal physicians. A second factor might be that the etiology of respiratory symptoms is not clearly understood and that different mechanisms might be accounting for respiratory
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Presented at the 62nd Annual Meeting of the Central Surgical Association, Tucson, Arizona, March 10-12, 2005.