Long-term results of the Angelchik prosthesis for gastro-oesophageal reflux.
BACKGROUND
Between 1982 and 1989, 46 patients had insertion of an Angelchik prosthesis for gastro-oesophageal reflux. Eleven patients (24 per cent) subsequently had the prosthesis removed, all but one for intractable dysphagia.


METHODS
Thirty-six of the original patients were followed by questionnaire, and 32 of these had a barium marshmallow swallow investigation.


RESULTS
A high proportion of patients (20 of 26) with a prosthesis in situ had symptoms of dysphagia. On objective evaluation by marshmallow swallow, the transit time was significantly slower than that of an age-matched control group (P < 0.01), but showed no significant deterioration with time compared with previous postinsertion studies.


CONCLUSIONS
The Angelchik prosthesis causes long-term dysphagia in a high proportion of patients, severe enough in one-quarter to necessitate its removal. Its continued use cannot, therefore, be recommended.
Maxwell-Armstrong
C A
CA
Department of Surgery, University Hospital, Nottingham, UK.
Steele
R J
RJ
Amar
S S
SS
Evans
D
D
Morris
D L
DL
Foster
G E
GE
Hardcastle
J D
JD
D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000601:surgery*; D005772:Gastrointestinal Transit; D006801:Humans; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants