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.