The Angelchik prosthesis: results and complications.
Fifty-four patients who had the Angelchik antireflux prosthesis inserted during the period March 1981 to May 1985 were sent a questionnaire and their medical records were reviewed. Forty-four patients replied: 68% said that they were cured, 25% said they were improved and two patients (4.5%) said they were worse after the operation. Of those who replied, 93% would recommend the procedure to others with a similar condition, 89% have had no further heartburn, and 72% have had no further regurgitation. However, it would appear from the responses that eight patients (18% of those who replied) have significant dysphagia not present before operation, at times varying from 8 months to 4 years and 10 months from operation (mean 38.5 months). Six additional patients (14%) had temporary dysphagia, now resolved and five patients (11%) have persisting minor dysphagia not present pre-operatively. Five respondents are known to have postoperative heartburn, two of whom are known to have persisting oesophagitis with ulceration. Nine patients (20%) continue to experience regurgitation, related to dysphagia in eight. Three prostheses have been removed without replacement; one after an oesophageal leak (believed to be related to a simultaneous parietal cell vagotomy), one for severe dysphagia and one which was unsuccessfully used to hold reduced a very large hiatus hernia. Two prostheses have been replaced after they slipped down the stomach wall, one with the tapes detached. (This latter prosthesis was one of the original ones with the tapes attached to the ends of the prosthesis only--a problem which has since been rectified by the manufacturer.) General surgical complications are listed for completeness.
Ritchie
P D
PD
Royal Canberra Hospital, Acton, Australian Capital Territory.
Milkins
R
R
Fleming
E L
EL
Nott
D
D
D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology; D004943:Esophagogastric Junction; D005260:Female; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects*