Esophagogastric Fistula Caused by an Angelchik Antireflux Prosthesis

Pence, Mark M.; Hubbard, Mark; Singla, Manish; Young, Patrick E.

doi:10.14309/crj.2015.62

Cited by 8 publications

(4 citation statements)

References 12 publications

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“…This fibrous capsule was seen intraoperatively in our patient during the removal of the AD. Other reported complications included migration of the device, erosion through the oesophagus, fistula formation and the development of adenocarcinoma proximal to the AD 7 8 10 11. Specifically, our patient developed end-stage oesophageal disease with a complete inability to swallow, necessitating the placement of a J-tube to allow for enteral nutritional support.…”

Section: Discussionmentioning

confidence: 89%

“…Jalil et al 14 described the laparoscopic removal of Angelchik prosthesis followed by an immediate Nissen’s fundoplication in a patient who had an AD for over 20 years 14. Others have demonstrated successful endoscopic removal of AD that had eroded through the oesophagus or created a fistula 8 11. Fewer reports, however, have demonstrated the removal of AD via a thoracotomy.…”

Section: Discussionmentioning

confidence: 99%

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Atypical dysphagia with end-stage oesophageal disease 30 years post Angelchik device placement in a 72-year-old man

et al. 2020

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Here we describe an atypical presentation of progressive dysphagia in a 72-year-old man leading to frequent regurgitations over the course of 30 years. Investigations revealed a foreign body ring surrounding the proximal stomach and dilation of the oesophagus proximal to the gastro-oesophageal junction. An Angelchik device was extracted; however, the patient’s rapid deterioration prior to surgery, in addition to his severely dysfunctional oesophagus, required placement of a jejunostomy feeding tube. Device removal was complicated by prior abdominal surgery, necessitating a thoracic approach. This case offers guidance on the management of patients with Angelchik prostheses who develop similar complications, while drawing attention to the importance and difficulties of early, definitive diagnosis in oesophageal pathology such as achalasia and gastro-oesophageal reflux disease.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Atypical dysphagia with end-stage oesophageal disease 30 years post Angelchik device placement in a 72-year-old man

et al. 2020

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“…12 Pence et al presented a patient who developed fistula 17 years after Angelchik prosthesis placement for refractory GERD. 17 Surgically induced ischemia and subsequent tissue necrosis, microscopic perforations, local ischemia, and stitch abscess may be contributing factors after a fundoplication procedure. 11,20,25 Another possibility is an iatrogenic fistula due to full-thickness suture, nasogastric tube trauma, 16,21,22 or dilation procedures.…”

Section: Discussionmentioning

confidence: 99%

Robotic Transgastric Reconstruction of the Double Lumen Esophagus

Gritsiuta

Bakhos

Petrov

et al. 2022

Innovations�(Phila)

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Double lumen esophagus is an extremely rare condition, developing in most cases as a complication of antireflux procedures or gastroesophageal reflux itself secondary to the severe inflammatory process in and around the lower esophagus. We describe a case of iatrogenic double lumen esophagus after multiple previous Nissen fundoplications for chronic gastroesophageal reflux disease. There is no standard surgical intervention for the management of this complication. We present a first report of successful robot-assisted surgical reconstruction of a double lumen esophagus.

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“…Concerns about possible complications and erosion of a foreign body placed at the gastroesophageal junction (GEJ) led to initial criticism because the past experience with the Angelchick and gastric banding devices [8,9]. Previously published studies demonstrated that the rate of MSA removal ranges from 1.1 to 6.7% [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Magnetic sphincter augmentation device removal: surgical technique and results at medium-term follow-up

Bona

Saino

Mini

et al. 2021

Langenbecks Arch Surg

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Background The magnetic sphincter augmentation (MSA) device has become a common option for the treatment of gastroesophageal reflux disease (GERD). Knowledge of MSA-related complications, indications for removal, and techniques are puzzled. With this study, we aimed to evaluate indications, techniques for removal, surgical approach, and outcomes with MSA removal. Methods This is an observational singe-center study. Patients were followed up regularly with endoscopy, pH monitoring, and assessed for specific gastroesophageal reflux disease health-related quality of life (GERD-HRQL) and generic short-form 36 (SF-36) quality of life. Results Five patients underwent MSA explant. Four patients were males and the median age was 47 years (range 44–55). Heartburn, epigastric/chest pain, and dysphagia were commonly reported. The median implant duration was 46 months (range 31–72). A laparoscopic approach was adopted in all patients. Intraoperative findings included normal anatomy (40%), herniation in the mediastinum (40%), and erosion (20%). The most common anti-reflux procedures were Dor (n = 2), Toupet (n = 2), and anterior partial fundoplication (n = 1). The median operative time was 145 min (range 60–185), and the median hospital length of stay was 4 days (range 3–6). The median postoperative follow-up was 41 months (range 12–51). At the last follow-up, 80% of patients were off PPI; the GERD-HRQL and SF-36 questionnaire were improved with DeMeester score and esophageal acid exposure normalization. Conclusion The MSA device can be safely explanted through a single-stage laparoscopic procedure. Tailoring a fundoplication, according to preoperative patient symptoms and intraoperative findings, seems feasible and safe with a promising trend toward improved symptoms and quality of life.

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Esophagogastric Fistula Caused by an Angelchik Antireflux Prosthesis

Cited by 8 publications

References 12 publications

Atypical dysphagia with end-stage oesophageal disease 30 years post Angelchik device placement in a 72-year-old man

Atypical dysphagia with end-stage oesophageal disease 30 years post Angelchik device placement in a 72-year-old man

Robotic Transgastric Reconstruction of the Double Lumen Esophagus

Magnetic sphincter augmentation device removal: surgical technique and results at medium-term follow-up

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