Laparoscopic antireflux surgery in patients with extra esophageal symptoms related to asthma

• Published in: Arquivos brasileiros de cirurgia digestiva : ABCD 2014-06, Vol.27 (2), p.92-95
• Main Authors: SILVA, Amanda Pinter Carvalheiro da, TERCIOTI-JUNIOR, Valdir, LOPES, Luiz Roberto, COELHO-NETO, João de Souza, BERTANHA, Laura, RODRIGUES, Paulo Rodrigo de Faria, ANDREOLLO, Nelson Adami
• Format: Article
• Language: English
• Subjects: Asma; Fundoplicatura; Original; Refluxo gastroesofágico; Videolaparoscopia
• ISSN: 0102-6720; 0102-6720; 2317-6326
• DOI: 10.1590/S0102-67202014000200002

BACKGROUND: Asthma, laryngitis and chronic cough are atypical symptoms of the gastroesophageal reflux disease. AIM: To analyze the efficacy of laparoscopic surgery in the remission of extra-esophageal symptoms in patients with gastroesophageal reflux, related to asthma. METHODS: Were reviewed the medical records of 400 patients with gastroesophageal reflux disease submitted to laparoscopic Nissen fundoplication from 1994 to 2006, and identified 30 patients with extra-esophageal symptoms related to asthma. The variables considered were: gender, age, gastroesophageal symptoms (heartburn, acid reflux and dysphagia), time of reflux disease, treatment with proton pump inhibitor, use of specific medications, treatment and evolution, number of attacks and degree of esophagitis. Data were subjected to statistical analysis, comparing the pre- and post-surgical findings. RESULTS: The comparative analysis before surgery (T1) and six months after surgery (T2) showed a significant reduction on heartburn and reflux symptoms. Apart from that, there was a significant difference between the patients with daily crises of asthma (T1 versus T2, 45.83% to 16.67%, p=0.0002) and continuous crises (T1, 41.67% versus T2, 8.33%, p=0.0002). CONCLUSION: Laparoscopic Nissen fundoplication was effective in improving symptoms that are typical of reflux disease and clinical manifestations of asthma. RACIONAL: A asma, a laringite e a tosse crônica são sintomas atípicos da doença do refluxo gastroesofágico. OBJETIVO: Analisar a eficácia da cirurgia laparoscópica na remissão de sintomas extra-esofágicos em doentes com refluxo gastroesofágico, relacionada com a asma. MÉTODOS: Foram revisados os prontuários de 400 doentes com doença do refluxo gastroesofágico submetidos à fundoplicatura a Nissen entre 1994 e 2006 e foram identificados 30 casos com sintomas extra-esofágicos relacionadas à asma. As variáveis consideradas foram: sexo, idade, sintomas gastroesofágicos (azia, refluxo ácido e disfagia), o tempo da doença do refluxo, o tratamento com inibidores da bomba de prótons, o uso de medicamentos específicos, tratamento e a evolução, o número de crises e o grau de esofagite. Os dados foram submetidos à análise estatística, comparando os resultados pré e pós-operatórios. RESULTADOS: A análise comparativa antes da operação (T1) e seis meses após (T2) mostrou redução significativa dos sintomas de azia e refluxo. Além disso, houve diferença significativa entre os doentes com crises diárias de asm