Laparoscopic anti-reflux surgery (LARS) is now well established as an effective treatment in the management of gastro-oesophageal reflux disease (GORD). Some of the reflux can be severe enough to cause upper respiratory symptoms such as laryngitis, hoarseness, chronic cough. Reflux resulting in aspiration can result in lower respiratory tract illnesses such as asthma and pulmonary fibrosis.
We aimed to analyse our data on LARS performed as a definite treatment in the management of refractory upper and lower respiratory diseases.
Data were analysed between January 1996 to October 2007. During this period 1107 LARS were performed. There was a total of 1006 cases of Laparoscopic Nissen fundoplication. 60 of these were performed for referrals other than reflux oesophagitis- from ear nose and throat (ENT) and respiratory departments- 26 from ENT and 34 from Respiratory specialties. The common causes for referral from ENT specialty was laryngitis, sinusitis, laryngospasm, hoarseness, sore throat and chronic cough. All the 60 patients reported improvement in symptoms. The significant finding of this study was that 41 (82%) of patients were off all medications indicating the effectiveness in curing the ENT and respiratory complications as a consequence of GORD. The median age for the patients was 44 years, range 16 to 88. There was no significant complication and all the procedures were completed laparoscopically.
LARS can be seen as a definitive treatment in failed medical management of upper and lower respiratory and ENT cases. The treatment is highly effective and allows patient to rid themselves of lifelong medication.
Take home message
LARS is highly effective and should be offered to cases of failed medical treatment of upper and lower respiratory tract illnesses arising from GORD.
Program Number: P363