Treatment of symptomatic gastroesophageal reflux using the Angelchik prosthesis.

Abstract:

:During the past 20 months, 28 patients with symptomatic gastroesophageal reflux were treated with the Angelchik anti-reflux prosthesis. The patients ranged in age from 12 to 75 years, with symptoms present from one to 24 years. Vigorous medical management had failed with all patients prior to surgery. Before operation, 28 of 28 patients had upper GI x-rays, 27 of 28 fiberoptic esophagogastroscopy, 26 of 27 esophageal biopsy, eight of 28 Bernstein testing, and 24 of 28 lower esophageal sphincter pressure and motility. Eight patients had strictures requiring preoperative or postoperative dilatation. In four of 28 patients, a Nissen procedure had been previously done. In addition, two patients had metaplastic epithelium, and a single patient a previous Heller myotomy. Twenty-five of the 28 patients are completely asymptomatic eight to 20 months after Angelchik insertion. Fifteen patients had surgery more than one year previously. There are no recurrent hiatal hernias. Endoscopy and biopsy reveal resolution or marked improvement in the esophagitis. Seven patients complained of transient dysphagia lasting up to three months. One patient has persistent "gas bloat" syndrome. There were no technical or perioperative complications. Trouble with the prosthesis occurred in two patients; in one, the prosthesis disrupted and fell into the pelvis, and in the other the prosthesis migrated into the mediastinum. LES pressures preoperatively were 6.17 +/- 0.9 and 16.95 +/- 1.76 mmHg for the 19 patients studied after operation. The limited sample of patients who were studied with preoperative and postoperative acid-reflux tests have all shown improvement in their score. The Angelchik prosthesis in this series has been safe, simple, and reproducible, and can eliminate the symptoms and signs of gastroesophageal reflux.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Starling JR,Reichelderfer MO,Pellett JR,Belzer FO

doi

10.1097/00000658-198206000-00002

subject

Has Abstract

pub_date

1982-06-01 00:00:00

pages

686-91

issue

6

eissn

0003-4932

issn

1528-1140

journal_volume

195

pub_type

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