The Angelchik antireflux device: a 5-year experience

Area of Science:

• Gastroenterology
• Surgical Innovation

Background:

• Gastroesophageal reflux disease (GERD) management often involves surgical interventions.
• The Angelchik antireflux prosthesis has been used to treat GERD.
• Evaluating long-term outcomes and complications of antireflux prostheses is crucial.

Purpose of the Study:

• To assess the efficacy and complications of the Angelchik antireflux prosthesis.
• To identify factors influencing patient outcomes after prosthesis insertion.
• To evaluate the impact of dysphagia as a presenting symptom.

Main Methods:

• A retrospective review of 44 patients who received the Angelchik prosthesis over 5 years.
• Follow-up interviews using a modified Visick grading system for 41 patients.
• Analysis of outcomes based on presenting symptoms (reflux vs. dysphagia) and follow-up duration.

Main Results:

• 74% of patients followed for ≥3 years had excellent or satisfactory outcomes.
• 92% of patients with reflux symptoms achieved relief.
• Less than 50% of patients with dysphagia had satisfactory outcomes; mild dysphagia increased with follow-up.
• Prosthesis migration was the primary cause of poor outcomes (Visick 3 or 4).

Conclusions:

• Dysphagia is a relative contraindication for Angelchik prosthesis insertion.
• Modified insertion techniques improved outcomes, with up to 92% achieving excellent or satisfactory results in recent series.
• Reducing prosthesis migration and fibrous tissue formation is key to successful prosthesis use.