Efficacy and safety of anti-reflux surgery in gastroesophageal-related cough: a systematic review and meta-analysis.

IF 12.5 2区医学 Q1 SURGERY

International journal of surgery Pub Date : 2024-08-30 DOI:10.1097/JS9.0000000000001998

Yuheng Liu, Junfeng Huang, Shuxin Zhong, Ziwen Zheng, Zhixing Xu, Dongda Zhou, Shuojia Xie, Zikai Lin, Shiyue Li, Ruchong Chen

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Abstract

Background: Gastroesophageal reflux disease (GERD) is a prevalent condition that manifests a spectrum of symptoms, including gastroesophageal-related cough (GERC). Anti-reflux procedures have been employed to alleviate these symptoms, yet their efficacy varies. This systematic review and meta-analysis aim to evaluate the improvement in gastroesophageal-related cough and other reflux symptoms following anti-reflux procedures.

Methods: A systematic review was performed by searching PubMed, Embase, and Cochrane Library. All observational studies reporting the improvement of GERC and other reflux symptoms after the anti-reflux procedures. Data were extracted and pooled using a random effects model to assess the overall effect size and heterogeneity between studies. We found that anti-reflux surgery has some clear benefits for common reflux-related symptoms.

Results: Fifty-nine eligible studies with 7431 patients with GERD were included in this study. The pooled cough remission rate was 80.0% (95%CI 75.4-84.2) and the mean time of follow up was 35.8 months. Anti-reflux surgery significantly improved overall reflux-related symptom scores (all P<0.001). We also assessed the rate of remission of other reflux symptoms. The pooled heartburn remission rate was 87.7% (95%CI 82.3-92.2) and the pooled regurgitation remission rate was 91.2%(95%CI 87.8-94.1).

Conclusion: Anti-reflux procedures significantly improve gastroesophageal-related cough and other reflux symptoms. These findings support the use of anti-reflux procedures as a viable treatment option for patients with GERD symptoms. Further research is needed to identify predictors of success and to optimize patient selection for anti-reflux procedures.

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抗反流手术治疗胃食管相关性咳嗽的有效性和安全性：系统回顾和荟萃分析。

背景：胃食管反流病（GERD）是一种常见病，表现出一系列症状，包括胃食管相关性咳嗽（GERC）。人们采用抗反流疗法来缓解这些症状，但其疗效参差不齐。本系统综述和荟萃分析旨在评估抗胃食管反流手术后胃食管相关咳嗽和其他反流症状的改善情况：方法：通过检索 PubMed、Embase 和 Cochrane 图书馆进行了系统综述。所有报道抗反流术后胃食管相关咳嗽和其他反流症状改善情况的观察性研究。采用随机效应模型对数据进行提取和汇总，以评估总体效应大小和研究间的异质性。我们发现，抗反流手术对常见的反流相关症状有一些明显的益处：本研究共纳入了 59 项符合条件的研究，共有 7431 名胃食管反流患者。咳嗽缓解率为 80.0%（95%CI 75.4-84.2），平均随访时间为 35.8 个月。抗反流手术明显改善了反流相关症状的总体评分（所有 PC 结论：抗反流手术能明显改善胃食管相关的咳嗽和其他反流症状。这些研究结果支持将抗反流手术作为治疗胃食管反流症状患者的一种可行方法。还需要进一步研究，以确定成功的预测因素，并优化抗反流手术的患者选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of surgery SURGERY-

CiteScore

17.70

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The International Journal of Surgery (IJS) has a broad scope, encompassing all surgical specialties. Its primary objective is to facilitate the exchange of crucial ideas and lines of thought between and across these specialties.By doing so, the journal aims to counter the growing trend of increasing sub-specialization, which can result in "tunnel-vision" and the isolation of significant surgical advancements within specific specialties.

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