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 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. 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.