Angelchik prosthesis with oesophageal adenocarcinoma: our surgical approach.
The Angelchik prosthesis is an incomplete doughnut-shaped device composed of silicone elastomer used in the treatment of gastro-oesophageal reflux disease (GORD). It is used to encircle the lower oesophagus at the gastro-oesophageal junction (GOJ). The ease of the operation led to the insertion of over 25,000 such prostheses world-wide. However, a variety of major complications including intractable dysphagia, prosthesis migration and gastric erosion required a quarter of these devices to be removed. Development of adenocarcinoma in patients with Angelchik prosthesis is a rare occurrence. This article describes two patients who developed adenocarcinoma above their prosthesis and whose cardio-oesophagectomy was technically challenging due to the formation of a dense inflammatory capsule around the prosthesis. Our surgical approach to curative oesophageal resection with the Angelchik prosthesis in situ is also discussed.
Shetty
V D
VD
Oesophagogastric Unit, Department of Surgery, Royal Preston Hospital, Preston, UK. anvindarsh@hotmail.com
Thrumurthy
S G
SG
Pursnani
K G
KG
Ward
J B
JB
Mughal
M M
MM
D000230:Adenocarcinoma / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods; D004942:Esophagitis, Peptic / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed