Persistent cough following pulmonary resection: observational and empiric study of possible causes.
BACKGROUND
Following thoracic surgery, patients often suffer from persistent coughing. There is speculation regarding the cause. However, since few studies of that following pulmonary resection have been reported, we conducted an observational and empiric study of this issue.


METHODS
A cross-sectional assessment of 240 patients who had undergone a pulmonary resection was performed using a questionnaire regarding postsurgical persistent coughing. Further, therapy based on empiric results was given to 20 patients who had undergone a lobectomy and mediastinal lymph node resection for nonsmall cell lung cancer.


RESULTS
Seventy patients were surveyed within 1 year following surgery (subchronic phase), of whom 35 (50%) suffered from coughing, as compared to 30 (18%) of 170 whose postoperative time was 1 year or more (p < 0.0001). Presence of lung cancer, mediastinal lymph node resection, and gastroesophageal reflux (GER) symptoms were significant factors in the group of subchronic patients. Of the 20 patients who received empiric therapy, 90% saw their coughing symptoms improve after the course of medication.


CONCLUSIONS
In the present patients, mediastinal lymph node resection may have contributed to coughing after the procedure, which tended to improve after 1 year following the operation. Further, a secondary change, such as GER, caused by surgical intervention may also be a contributing factor in the subchronic phase.
Sawabata
Noriyoshi
N
Division of Surgery, Toneyama National Hospital, Toyonaka, Osaka, Japan. nsawabata@m5.dion.ne.jp
Maeda
Hajime
H
Takeda
Shin-ichi
S
Inoue
Masayoshi
M
Koma
Masaru
M
Tokunaga
Toshiteru
T
Matsuda
Hikaru
H
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000368:Aged; D001549:Benzamides / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery; D002908:Chronic Disease; D003371:Cough / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000188:drug therapy; D005765:Gastrointestinal Agents; D006801:Humans; D064747:Lansoprazole; D008171:Lung Diseases / Q000601:surgery; D008175:Lung Neoplasms / Q000601:surgery; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000627:therapeutic use; D009853:Omeprazole / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000209:etiology*; D011187:Posture; D054328:Proton Pump Inhibitors; D011795:Surveys and Questionnaires; D014891:Weight Lifting
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D001549:Benzamides; D005765:Gastrointestinal Agents; D009025:Morpholines; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; C062720:mosapride; D009853:Omeprazole