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Shin-ichi Takeda
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Ann Thorac Surg 2005;79:289-293
© 2005 The Society of Thoracic Surgeons

Original article: General thoracic

Persistent Cough Following Pulmonary Resection: Observational and Empiric Study of Possible Causes

Noriyoshi Sawabata, MDa,b,*, Hajime Maeda, MDa,b, Shin-ichi Takeda, MDa,b, Masayoshi Inoue, MDb, Masaru Koma, MDa,b, Toshiteru Tokunaga, MDa,b, Hikaru Matsuda, MDb

a Division of Surgery, Toneyama National Hospital, Osaka, Japan
b Department of Surgery (E-1), Osaka University, Graduate School of Medicine, Suita, Japan

Accepted for publication June 11, 2004.

* Address reprint requests to Dr Sawabata, Division of Surgery, Toneyama National Hospital, 5–1–1, Toneyama, Toyonaka, Osaka 560–8552, Japan (E-mail: nsawabata{at}m5.dion.ne.jp).

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.






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