保存的治療抵抗性咽喉頭逆流症に対する腹腔鏡下逆流防止術(LARS)の検討

鈴木 猛司; 関 洋介; 松村 倫明; 櫻井 大樹; 花澤 豊行; 岡本 美孝; 北方 敏敬

doi:10.5426/larynx.32.29

The Outcome of Anti-reflux Surgery for Patients with Laryngopharyngeal Reflux Disease

Takeshi Suzuki, Yosuke Seki, Tomoaki Matsumura, Daijyu Sakurai, Toyoyuki Hanazawa, Yoshitaka Okamoto, Toshitaka Hoppo

Author information

Keywords: laryngopharyngeal reflux disease : LPRD, laparoscopic anti-reflux surgery : LARS, hypopharyngeal multichannel intraluminal impedance–pH metry : HMII, abnormal proximal exposure : APE, full column reflux : FCR

JOURNAL FREE ACCESS

2020 Volume 32 Issue 01 Pages 29-36

DOI https://doi.org/10.5426/larynx.32.29

Details

Abstract

Objective: To assess the efficacy of laparoscopic anti-reflux surgery (LARS) for treating Japanese patients with laryngopharyngeal reflux disease (LPRD) refractory to proton pump inhibitor (PPI) therapy.

Methods: The outcomes of LARS were retrospectively assessed using validated questionnaires, such as the reflux symptom index (RSI), in Japanese LPRD patients with abnormal proximal exposure (APE) as measured by hypopharyngeal multichannel intraluminal impedance-pH (HMII).

Results: Twenty-eight patients with LPR symptoms and documented APE underwent LARS. Of these patients, 26 (93%) saw significant symptomatic improvement, and their RSI values significantly improved postoperatively (19.8 ± 10.8 vs. 7.3 ± 8.1, p<0.001). A mild retrosternal food-sticking sensation was reported in 5 patients (18%) postoperatively.

Conclusion: LARS is an effective treatment for patients with LPR symptoms and documented APE as measured by HMII. HMII is essential for the evaluation of patients with LPR symptoms.

Corresponding author

Register with J-STAGE for free!