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Published on: February 10, 2020
Esophageal adenocarcinoma developing above an Angelchik prosthesis
S J Mercer1, S K C Toh, S S Somers
1Solent Center for Digestive Diseases, Queen Alexandra Hospital, Cosham, Portsmouth, PO6 3LY, UK. mercersurgeon@hotmail.com
Summary
The Angelchik device, used for gastro-esophageal reflux disease, had limited symptom control and serious complications. It may not prevent esophageal adenocarcinoma, suggesting it doesn't halt the progression from dysplasia to cancer.
Area of Science:
- Gastroenterology and Surgical Oncology
Background:
- The Angelchik device, a silicone elastomer prosthesis, was surgically implanted via trans-abdominal route to treat gastro-esophageal reflux disease (GERD).
- Over 25,000 devices were implanted globally, with reported symptom control rates between 54% and 95%.
Observation:
- Despite initial success, the device was linked to severe complications like dysphagia, migration, and erosion.
- A significant number of patients required prosthesis removal due to these complications.
Findings:
- This article reports three cases where patients developed esophageal adenocarcinoma after Angelchik prosthesis insertion.
- The study suggests the Angelchik device is ineffective in preventing acid reflux.
- Consequently, it does not impede the dysplasia-metaplasia-adenocarcinoma sequence in the esophagus.
Implications:
- The findings question the long-term efficacy and safety of the Angelchik device in managing GERD.
- There is a potential link between the device and the development of esophageal adenocarcinoma.
- Further research is needed to understand the risks associated with this GERD treatment.
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