Long-term outcomes after laparoscopic Nissen fundoplication for reflux laryngitis

Dig Surg. 2010;27(6):509-14. doi: 10.1159/000321883. Epub 2010 Dec 23.

Abstract

Background: The surgical treatment of gastroesophageal reflux-induced reflux laryngitis remains controversial. The aim of this study was to determine both long-term objective endoscopic findings and subjective symptomatic outcomes after laparoscopic Nissen fundoplication in patients operated on for reflux laryngitis.

Methods: 40 consecutive patients with pH-proven reflux laryngitis underwent laparoscopic Nissen fundoplication between 1998 and 2002. 68% (n = 27) of these patients underwent an endoscopic evaluation and 90% (n = 36) were available for the subjective long-term outcome (personal interviews).

Results: At a median follow-up of 91 months there were no disrupted plications, none of the patients had esophagitis but 3 recurrent hiatal hernias were detected. 61% of the patients reported no or only mild reflux laryngitis symptoms postoperatively and 69% of the patients evaluated their voice quality improved after surgery. 94% of the patients were satisfied with their surgical result. With benefit of hindsight, 11% of the patients would not choose surgical treatment and 42% had reinitiated antireflux medications postoperatively.

Conclusion: The majority of pH-proven gastroesophageal reflux-induced reflux laryngitis patients attain long-term symptomatic benefit and satisfaction on the surgical outcome, and with proper patient selection laparoscopic Nissen fundoplication provides a feasible long-term treatment option for reflux laryngitis.

MeSH terms

  • Follow-Up Studies
  • Fundoplication*
  • Gastroesophageal Reflux / complications*
  • Gastroesophageal Reflux / surgery
  • Hernia, Hiatal
  • Humans
  • Interviews as Topic
  • Laparoscopy*
  • Laryngitis / etiology
  • Laryngitis / surgery*
  • Laryngoscopy
  • Treatment Outcome
  • Voice Quality