title: Long-term results of the Angelchik prosthesis for gastro-oesophageal reflux.
abstract: 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.
authors.affiliation: Department of Surgery, University Hospital, Nottingham, UK.
authors.forename: C A
authors.initials: CA
authors.lastname: Maxwell-Armstrong
authors.forename: R J
authors.initials: RJ
authors.lastname: Steele
authors.forename: S S
authors.initials: SS
authors.lastname: Amar
authors.forename: D
authors.initials: D
authors.lastname: Evans
authors.forename: D L
authors.initials: DL
authors.lastname: Morris
authors.forename: G E
authors.initials: GE
authors.lastname: Foster
authors.forename: J D
authors.initials: JD
authors.lastname: Hardcastle
mesh_terms: 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