[Laparoscopic fundoplication results in the treatment of the non-gastrointestinal symptoms of gastroesophageal reflux]. / Resultados de la funduplicatura laparoscópica en el tratamiento de los síntomas extradigestivos del reflujo gastroesofágico.

INTRODUCTION: Gastroesophageal reflux disease (GERD) can trigger typical and atypical symptoms (cough, dysphonia, asthma…). GERD with typical symptoms has well established surgical indications, but it is not the case when the symptoms are atypical. Our aim is to assess the effectiveness of laparoscopic surgery in those patients in whom the surgical indication was mainly due to atypical symptoms. MATERIAL AND METHODS: Between 1998 and 2011 laparoscopic fundoplication was performed on of 318 patients with GERD, of whom 14 (4%) had atypical symptoms as the main indication. Typical symptoms were present in 12 (86%) cases, and atypical symptoms were: cough in 5 (36%) cases, respiratory symptoms 5 (36%), dysphonia 2 (14%), vocal chords granuloma 1 (7%) and larynx spasm 1 (7%). The GERD diagnosis was established due to evidence of an anatomical or functional alterations of the gastroesophageal junction (hiatus hernia, pathological manometry or pH-metry). The clinical histories of the patients were reviewed and they were given a gastrointestinal quality of life (Gastrointestinal Quality of Life Index [GIQoL]) questionnaire was completed, as well as a subjective assessment (0 to 4) of the modification of their atypical symptoms. RESULTS: A clinical improvement was observed in both the atypical and typical GERD in 12 patients (86%), with the symptoms score decreasing from 3.7 to 0.7. A significant improvement (P<.05) from the pre-surgical value 107(±26) to 122 (±10) points was obtained in the quality of life (GIQoL) in 11 patients (79%). CONCLUSION: Laparoscopic fundoplication is an effective technique in the treatment of the atypical symptoms of GERD.

Resultados de la funduplicatura laparoscópica en el tratamiento de los síntomas extradigestivos del reflujo gastroesofágico / Laparoscopic fundoplication results in the treatment of the non-gastrointestinal symptoms of gastroesophageal reflux

Introducción La enfermedad por reflujo gastroesofágico (ERGE) puede desencadenar síntomas típicos y atípicos (tos, disfonía, asma...). La ERGE con síntomas típicos tiene indicaciones quirúrgicas bien establecidas, no es así cuando los síntomas son atípicos. Nuestro propósito es valorar la efectividad de la cirugía laparoscópica en aquellos pacientes en los que la indicación quirúrgica fue principalmente por sintomatología atípica. Material y métodos Entre 1998 y 2011 se intervinieron por ERGE mediante funduplicatura laparoscópica 318 pacientes de los cuales 14 (4%) tuvieron como indicación principal un síntoma atípico. La sintomatología típica se presentó en 12 casos (86%) y la atípica fue: tos 5 casos (36%), síntomas respiratorios 5 (36%), disfonía 2 (14%), granuloma de cuerdas vocales 1 (7%) y laringoespasmo 1 (7%). El diagnóstico de ERGE se estableció ante la evidencia de una alteración anatómica o funcional de la unión gastroesofágica (hernia de hiato, manometría o pH-metría patológica). Se revisó el historial clínico de los pacientes y se pasó un cuestionario de calidad de vida gastrointestinal (Gastrointestinal Quality of Life Index [GIQLI]) así como una valoración subjetiva (0 a 4) de la modificación de su sintomatología atípica. Resultados En la evaluación se observó una mejoría tanto de la clínica típica como de la atípica de ERGE en 12 pacientes (86%), disminuyendo el score sintomático de 3,7 a 0,7. Se obtuvo el test de calidad de vida (GIQLI) en 11 pacientes (79%), con una mejoría significativa (p<0,05) del valor prequirúrgico 107(±26) a 122 (±10) puntos. Conclusión La funduplicatura laparoscópica es una técnica efectiva en el tratamiento de la sintomatología atípica de la ERGE (AU)

Introduction Gastroesophageal reflux disease (GERD) can trigger typical and atypical symptoms (cough, dysphonia, asthma...). GERD with typical symptoms has well established surgical indications, but it is not the case when the symptoms are atypical. Our aim is to assess the effectiveness of laparoscopic surgery in those patients in whom the surgical indication was mainly due to atypical symptoms. Material and methods Between 1998 and 2011 laparoscopic fundoplication was performed on of 318 patients with GERD, of whom 14 (4%) had atypical symptoms as the main indication. Typical symptoms were present in 12 (86%) cases, and atypical symptoms were: cough in 5 (36%) cases, respiratory symptoms 5 (36%), dysphonia 2 (14%), vocal chords granuloma 1 (7%) and larynx spasm 1 (7%). The GERD diagnosis was established due to evidence of an anatomical or functional alterations of the gastroesophageal junction (hiatus hernia, pathological manometry or pH-metry). The clinical histories of the patients were reviewed and they were given a gastrointestinal quality of life (Gastrointestinal Quality of Life Index [GIQoL]) questionnaire was completed, as well as a subjective assessment (0 to 4) of the modification of their atypical symptoms. Results A clinical improvement was observed in both the atypical and typical GERD in 12 patients (86%), with the symptoms score decreasing from 3.7 to 0.7. A significant improvement (P<.05) from the pre-surgical value 107(±26) to 122 (±10) points was obtained in the quality of life (GIQoL) in 11 patients (79%).Conclusion Laparoscopic fundoplication is an effective technique in the treatment of the atypical symptoms of GERD (AU)