Long-term results of the Angelchik prosthesis for gastro-oesophageal reflux

Introduction Between 1982 and 1989, 46 patients had insertion of an Angelchik prosthesis for gastrooesophageal 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 post-insertion studies. Conclusion 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.