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首页> 外文期刊>Surgical Endoscopy >Preoperative symptom evaluation and esophageal acid infusion predict response to laparoscopic Nissen fundoplication in gastroesophageal reflux patients who present with cough.
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Preoperative symptom evaluation and esophageal acid infusion predict response to laparoscopic Nissen fundoplication in gastroesophageal reflux patients who present with cough.

机译：术前症状评估和食管酸输注可预测出现咳嗽的胃食管反流患者对腹腔镜尼森胃底折叠术的反应。

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摘要

BACKGROUND: Most patients with cough and gastroesophageal reflux disease (GERD) improve on medical treatment with proton pump inhibitors (PPI). Nonresponders may be considered for antireflux surgery, but the selection of patients is difficult. METHODS: We have performed laparoscopic Nissen fundoplications (LNF) in 677 patients. Of these patients, 81% have undergone 6-month follow-up assessment with 24-h pH testing, esophageal manometry, symptom scores, and quality-of-life scores. RESULTS: LNF controlled heartburn in 93% and improved cough in 81%. Stepwise multiple regression showed that the preoperative cough score (r = 0.620, p <0.0001) and change in cough on and off PPI (r = 0.296, p = 0.0002) predicted improvement after surgery. A positive result on a randomized acid infusion test was associated with a greater improvement in cough after surgery (p = 0.0243). CONCLUSION: An acid infusion test and assessment of cough on and off PPI may be useful preoperative tools for the selection of patients with cough for LNF.
机译：背景：大多数患有咳嗽和胃食管反流病（GERD）的患者在使用质子泵抑制剂（PPI）进行药物治疗时会有所改善。无反应者可考虑进行抗反流手术，但患者的选择很困难。方法：我们对677例患者进行了腹腔镜尼森胃底折叠术（LNF）。在这些患者中，有81％接受了为期6个月的随访评估，包括24小时pH测试，食管测压，症状评分和生活质量评分。结果：LNF控制的烧心率为93％，咳嗽的改善率为81％。逐步多元回归分析表明，术前咳嗽评分（r = 0.620，p <0.0001）和开/关PPI的咳嗽变化（r = 0.296，p = 0.0002）预示手术后好转。随机输注酸试验的阳性结果与手术后咳嗽的更大改善相关（p = 0.0243）。结论：酸输注测试和评估PPI的开/关可能是选择LNF咳嗽患者的术前有用工具。

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