The Angelchik antireflux prosthesis: long-term clinical and technical follow-up.
OBJECTIVE
To evaluate the long-term clinical outcome and compare the rupture rate of the two generations of the silicone Angelchik antireflux prosthesis.


METHODS
A cohort study. Follow-up ranged from 61 to 119 months.


METHODS
A university teaching hospital.


METHODS
Sixty-three patients: 33 patients received the first generation Angelchik device (group 1) and 30 patients received a second generation design (group 2). The two groups were comparable for sex ratio, mean age and duration of symptoms.


METHODS
Implantation of the Angelchik prosthesis.


METHODS
Comparison of the rupture rate and migration of the prosthesis as assessed by patient questionnaire, telephone interview and radiography of the abdomen.


RESULTS
The prosthesis remained in a good position in 53% of group 1 patients and 93% of group 2 patients. The prosthesis was removed in 40% of group 1 patients, most often for rupture, and in only 7% of patients in group 2, to relieve dysphagia (p < 0.01). Grading on a Visick scale demonstrated a good result in 37% of group 1 patients and 69% of group 2 patients. Long-term dysphagia was the most prevalent adverse effect, seen in 45% of patients whose prosthesis was in a good position, and symptomatic reflux recurred in 8%.


CONCLUSIONS
The second generation of the Angelchik prosthesis, resulted in a reduced rupture rate of the prosthesis. Nevertheless the high complication and the failure rates militate against continued implantation of the prosthesis.
Thibault
C
C
Department of Surgery, Hôpital Laval, Sainte-Foy, Que.
Marceau
P
P
Biron
S
S
Bourque
R A
RA
Béland
L
L
Potvin
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019736:Prostheses and Implants / Q000009:adverse effects; D011475:Prosthesis Failure; D012008:Recurrence; D012828:Silicones; D017211:Treatment Failure
D012828:Silicones