Ca. Maxwellarmstrong et al., LONG-TERM RESULTS OF THE ANGELCHIK PROSTHESIS FOR GASTROESOPHAGEAL REFLUX, British Journal of Surgery, 84(6), 1997, pp. 862-864
Introduction Between 1982 and 1989, 46 patients had insertion of an An
gelchik prosthesis for gastrooesophageal reflux. Eleven patients (24 p
er cent) subsequently had the prosthesis removed, all but one for intr
actable dysphagia. Methods Thirty-six of the original patients were fo
llowed by questionnaire, and 32 of these had a barium marshmallow swal
low investigation. Results A high proportion of patients (20 of 26) wi
th a prosthesis in situ had symptoms of dysphagia. On objective evalua
tion by marshmallow swallow, the transit time was significantly slower
than that of an age-matched control group (P < 0.01), but showed no s
ignificant deterioration with time compared with previous post-inserti
on studies. Conclusion The Angelchik prosthesis causes long-term dysph
agia in a high proportion of patients, severe enough in one-quarter to
necessitate its removal. Its continued use cannot, therefore, be reco
mmended.