RESULTS OF A PROSPECTIVE RANDOMIZED TRIAL OF THE ANGELCHIK PROSTHESISAND OF A CONSECUTIVE SERIES OF 119 PATIENTS

The results of a randomized multicentre trial comparing the Angelchik prosthesis with floppy Nissen fundoplication for gastro-oesophageal re flux were assessed 4-6 years after surgery. Of the original 52 patient s 48 were traced. A good or excellent result (Visick grade 1 or 2) was obtained in 21 of 25 after insertion of the Angelchik prosthesis comp ared with 18 of 23 after fundoplication. Poor results were due to recu rrent heartburn after fundoplication and to dysphagia after prosthesis insertion. In a separate consecutive series of 119 patients receiving Angelchik prostheses, results were good or excellent in 101 (85 per c ent) and poor in 18 (15 per cent). Control of reflux with a correctly positioned prosthesis was good. Troublesome dysphagia (Visick grade 3 or 4) was experienced in eight of the 119 patients. There was no morta lity and no incidence of splenectomy or gas-bloat syndrome.