Chinese expert consensus on the diagnosis and treatment of chronic cough after lung surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Gaoxiang ¹ , ZHANG Junqiang ² , WU Mingsheng ¹ , WANG Sheng ³ , ZHU Yongfu ⁴ , LI Xuejiao ⁵ , CHEN Zhengwei ¹ ,  XIE Mingran ¹ , Representatives of Thoracic Surgery Committee of Anhui Medical Association , Thoracic Tumor Surgery Committee of Anhui Society of Clinical Oncology , Lung Cancer Specialized Committee of Anhui Anti-Cancer Association , Thoracic Surgery Specialized Committee of Anhui Province Minimally Invasive Medicine Association

1. Department of Thoracic Surgery, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei, 230001, P. R. China;
2. Department of Respiratory Medicine, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei, 230001, P. R. China;
3. Department of Anesthesiology, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei, 230001, P. R. China;
4. Department of Oncology, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, P. R. China;
5. Anhui University of Chinese Medicine, Hefei, 230012, P. R. China;

Corresponding?author：

XIE Mingran, Email: xmr1981@ustc.edu.cn

Keywords：

Pulmonectomy; chronic cough; treatment; expert consensus

DOI：

10.7507/1007-4848.202309028

Video：

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In recent years, the number of lung surgeries has increased year by year, and the number of patients with postoperative cough has also increased gradually. Chronic cough after lung surgery seriously affects patients' quality of life and surgical outcome, and has become one of the clinical problems that clinicians need to solve. However, there is currently no guideline or consensus for the treatment of chronic cough after lung surgery in China, and there is no standardized treatment method. Therefore, we searched databases such as PubMed, Web of Science, CNKI, and Wanfang databases ect. from 2000 to 2023 to collected relevant literatures and research data, and produced the first expert consensus on chronic cough after lung surgery in China by Delphi method. We gave 11 recommendations from five perspectives including timing of chronic cough treatment, risk factors (surgical method, lymph node dissection method, anesthesia method), prevention methods (preoperative, intraoperative, postoperative), and treatment methods (etiological treatment, cough suppressive drug treatment, traditional Chinese medicine treatment, and postoperative physical therapy). We hope that this consensus can improve the standardization and effectiveness of chronic cough treatment after lung surgery, provide reference for clinical doctors, and ultimately improve the quality of life of patients with chronic cough after lung surgery.

Citation： WANG Gaoxiang, ZHANG Junqiang, WU Mingsheng, WANG Sheng, ZHU Yongfu, LI Xuejiao, CHEN Zhengwei, XIE Mingran, Representatives of Thoracic Surgery Committee of Anhui Medical Association, Thoracic Tumor Surgery Committee of Anhui Society of Clinical Oncology, Lung Cancer Specialized Committee of Anhui Anti-Cancer Association, Thoracic Surgery Specialized Committee of Anhui Province Minimally Invasive Medicine Association. Chinese expert consensus on the diagnosis and treatment of chronic cough after lung surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(1): 1-10. doi: 10.7507/1007-4848.202309028 Copy

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1. Siegel RL, Miller KD, Wagle NS, et al. Cancer statistics, 2023. CA Cancer J Clin, 2023, 73(1): 17-48.
2. Sung H, Ferlay J, Siegel R L, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
3. Cao W, Chen HD, Yu YW, et al. Changing profiles of cancer burden worldwide and in China: A secondary analysis of the global cancer statistics 2020. Chin Med J (Engl), 2021, 134(7): 783-791.
4. Sawabata N, Takeda S, Tokunaga T, et al. Acid regurgitation associated with persistent cough after pulmonary resection: An observational study. Cough, 2006, 2: 9.
5. 李理響, 汪國文, 王康武, 等. 肺切除術后不可耐受性咳嗽的危險因素分析. 中華解剖與臨床雜志, 2022, 27(7): 491-495.
6. Ishibashi H, Wakejima R, Kurihara Y, et al. Extubation by supraglottic airway after lobectomy prevents cough-associated air leaks and prolonged coughing or sore throat. Eur J Cardiothorac Surg, 2023, 65(3): ezad158.
7. Lowery AE, Krebs P, Coups EJ, et al. Impact of symptom burden in post-surgical non-small cell lung cancer survivors. Support Care Cancer, 2014, 22(1): 173-180.
8. Irwin RS, Glomb WB, Chang AB. Habit cough, tic cough, and psychogenic cough in adult and pediatric populations: ACCP evidence-based clinical practice guidelines. Chest, 2006, 129(1 Suppl): 174S-179S.
9. Dicpinigaitis PV, Tso R, Banauch G. Prevalence of depressive symptoms among patients with chronic cough. Chest, 2006, 130(6): 1839-1843.
10. Li X, Li X, Zhang W, et al. Factors and potential treatments of cough after pulmonary resection: A systematic review. Asian J Surg, 2021, 44(8): 1029-1036.
11. 鄧城慶, 朱曉雷. 胸腔鏡肺葉切除術后咳嗽的研究進展. 中國微創外科雜志, 2020, 20(4): 354-357.
12. 中華醫學會呼吸病學分會哮喘學組. 咳嗽的診斷與治療指南(2021). 中華結核和呼吸雜志, 2022, 45(1): 13-46.
13. Irwin RS, Baumann MH, Bolser DC, et al. Diagnosis and management of cough executive summary: ACCP evidence-based clinical practice guidelines. Chest, 2006, 129(1 Suppl): 1S-23S.
14. Kardos P, Dinh QT, Fuchs KH, et al. German Respiratory Society guidelines for diagnosis and treatment of adults suffering from acute, subacute and chronic cough. Respir Med, 2020, 170: 105939.
15. 中華醫學會, 中華醫學會雜志社, 中華醫學會全科醫學分會, 等. 咳嗽基層診療指南(2018年). 中華全科醫師雜志, 2019, 18(3): 207-219.
16. Mu T, Li J, Huang Q, et al. Characteristics and risk factors for persistent cough after pulmonary resection. Ann Thorac Surg, 2023, 115(6): 1337-1343.
17. 慕騰, 姜冠潮, 李曉, 等. 胸腔鏡肺切除術后持續咳嗽的多因素分析. 中國微創外科雜志, 2017, 17(7): 577-580.
18. Mazzone SB, Undem BJ. Vagal afferent innervation of the airways in health and disease. Physiol Rev, 2016, 96(3): 975-1024.
19. Canning BJ, Chang AB, Bolser DC, et al. Anatomy and neurophysiology of cough: CHEST guideline and expert panel report. Chest, 2014, 146(6): 1633-1648.
20. Lucanska M, Hajtman A, Calkovsky V, et al. Upper airway cough syndrome in pathogenesis of chronic cough. Physiol Res, 2020, 69(Suppl 1): S35-S42.
21. Ahmad SR, Iyer VN. The evolving clinical practice of chronic cough. Mayo Clin Proc, 2022, 97(6): 1164-1175.
22. 張楠, 陳星, 林鏗強, 等. 保留迷走神經肺支對胸腔鏡上葉肺癌根治術后咳嗽的影響: 前瞻性隨機對照研究. 福建醫藥雜志, 2023, 45(1): 1-4.
23. Huang QW, Li JB, Huang Y, et al. A comparison of analgesia after a thoracoscopic lung cancer operation with a sustained epidural block and a sustained paravertebral block: A randomized controlled study. Adv Ther, 2020, 37(9): 4000-4014.
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