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. 李理响, 汪国文, 王康武, 等. 肺切除术后不可耐受性咳嗽的危险因素分析. 中华解剖与临床杂志, 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. 邓城庆, 朱晓雷. 胸腔镜肺叶切除术后咳嗽的研究进展. 中国微创外科杂志, 2020, 20(4): 354-357.
12. 中华医学会呼吸病学分会哮喘学组. 咳嗽的诊断与治疗指南(2021). 中华结核和呼吸杂志, 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. 中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 咳嗽基层诊疗指南(2018年). 中华全科医师杂志, 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. 慕腾, 姜冠潮, 李晓, 等. 胸腔镜肺切除术后持续咳嗽的多因素分析. 中国微创外科杂志, 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. 张楠, 陈星, 林铿强, 等. 保留迷走神经肺支对胸腔镜上叶肺癌根治术后咳嗽的影响: 前瞻性随机对照研究. 福建医药杂志, 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.
24. 王子涵, 沈杰, 罗艳. 复合脊神经阻滞用于单孔胸腔镜下肺段/叶切除术的镇痛效果. 上海交通大学学报(医学版), 2021, 41(8): 1062-1067.
25. Ma W, Yu L, Wang Y, et al. Changes in health-related quality of life and clinical implications in Chinese patients with chronic cough. Cough, 2009, 25(5): 7.
26. 徐志华, 林嵘嘉, 车国卫, 等. 肺术后咳嗽评估—中文版莱斯特咳嗽量表的应用价值. 中国肺癌杂志, 2017, 20(6): 389-394.
27. 林嵘嘉, 车国卫, 徐志华, 等. 中文版莱斯特咳嗽问卷的改良及验证. 中国肺癌杂志, 2017, 20(7): 468-472.
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