LONG-TERM RESULTS OF THE ANGELCHIK PROSTHESIS FOR GASTROESOPHAGEAL REFLUX

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.