Laparoscopic Toupet Fundoplication for the Treatment of Laryngopharyngeal Reflux: Results at Medium-Term follow-Up
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ORIGINAL SCIENTIFIC REPORT
Laparoscopic Toupet Fundoplication for the Treatment of Laryngopharyngeal Reflux: Results at Medium-Term follow-Up Alberto Aiolfi1 • Marta Cavalli2 • Greta Saino1 • Desmond Khor3 • Andrea Sozzi1 Emanuele Rausa1 • Gianluca Bonitta1 • Davide Bona1
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Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Background The effect of laparoscopic Toupet fundoplication (LTF) for the treatment of laryngopharyngeal reflux (LPR) is unclear. The purpose of this study is to investigate the feasibility and effectiveness of LTF for the treatment of LPR-related symptoms and disease-specific quality of life (QoL) up to 3-year follow-up. Materials and methods Observational cohort study (2015–2019). Patients suffering from LPR were included. Preoperative evaluation included esophagogastroduodenoscopy, esophageal manometry and 24-h pH/impedance study. Symptoms and QoL were measured with the reflux symptom index (RSI) and the laryngopharyngeal reflux–healthrelated quality of life (LPR–HRQL) validate questionnaires at baseline and during follow-up. Results Eighty-six patients were included. Twenty-three (27%) patients had pure LPR while 63 (73%) presented with combined LPR/GERD. Cough (89.7%), dyspnea/choking (39.6%) and asthma (25.6%) were the most commonly reported extraesophageal symptoms. The median (interquartile range, IQR) total RSI score before operation and at 3-month, 6-month, 1-year, 2-year and 3-year follow-up was 36.1 (10.3), 9.58 (12.3), 11.8 (10.2), 12.4 (9.6), 12.0 (13.1) and 10.1 (12.0), respectively. The median (IQR) total LPR–HRQL score before operation and at 3-month, 6-month, 1-year, 2-year and 3-year follow-up was 57.4 (22.2), 13.4 (14.9), 15.2 (12.8), 11.4 (10.9) and 11.9 (13.5), respectively. The subscores ‘‘voice,’’ ‘‘cough,’’ ‘‘throat’’ and ‘‘swallow’’ showed a significant improvement after intervention. Compared to baseline, each per-year follow-up pairwise comparison was significantly improved (p \ 0.001). Conclusions LTF seems feasible, effective and promising for the treatment of LPR with improved symptoms and disease-specific patients’ quality of life perception up to 3-year follow-up.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00268-020-05653-5) contains supplementary material, which is available to authorized users. & Alberto Aiolfi [email protected]
Andrea Sozzi [email protected]
Marta Cavalli [email protected]
Emanuele Rausa [email protected]
Greta Saino [email protected]
Gianluca Bonitta [email protected]
Desmond Khor [email protected]
Davide Bona [email protected]
123
World J Surg
Introduction Gastroesophageal reflux disease (GERD) is common, with heartburn, regurgitation, dysphagia and chest pain being considered as typical esophageal symptoms [1]. On the other hand, laryngopharyngeal reflux (LPR) is rarely reported and related to chronic upper airway contact with acidic and non-acidic reflux and aerosol causing posterior laryngitis with edema and interarytenoid/g
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