Intractable Dysphagia Following Placement of Angelchik Prosthesis for Remix Esophagitis

Battaglini, James W.; Schorlemmer, Gilbert R.; Frantz, Paul T.

doi:10.1016/s0003-4975(10)60433-x

Cited by 14 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our reported removal rate of 15% (10/65) is in accordance with other reports (5-17%) [9,10,14,27,29] but much lower than the removal rate of 24% reported recently by Maxwell-Armstrong et al [18]. Dysphagia has been the most common and troublesome symptom after the insertion of the AP.…”

Section: Discussionsupporting

confidence: 92%

Angelchik Prosthesis Revisited

et al. 2001

View full text Add to dashboard Cite

There are few long-term follow-up reports of the Angelchik prosthesis (AP). We report the longest follow-up series (66-192 months, average 145 months) to date. Between October 1983 and January 1994, 65 patients (45 men and 20 women) aged between 29 and 84 years (mean 52 years) had an AP inserted for gastro-oesophageal reflux (GOR) with or without hiatus hernia (HH). Clinical, radiological, endoscopy, and operative details were reviewed. Postoperative complications, investigations, and follow-up details were critically analyzed. All living patients (n = 53) with an AP in situ were interviewed and symptomatic assessment was carried out using a modified Visick system (I-IV). The average duration of the GOR symptoms before the operation was 5.7 years (range 10 months to 20 years). The average hospital stay was 8 days (range 5-15 days). Postoperatively, five patients developed chest infection/atelectasis, four had superficial wound infection, two had deep vein thrombosis (one with pulmonary embolism), one had urinary retention, and four developed an incisional hernia. Six patients (three with an AP in situ) died of other medical conditions. Ten (15%) patients had removal of the prosthesis. Eight (12%) and 11 (17%) had transient and persistent dysphagia, respectively. Thirteen (20%) and five (8%) patients had distal slippage and proximal migration of the prosthesis, respectively. One patient had erosion of the AP into the stomach, while in another patient, the straps of the prosthesis ruptured. Of the 53 living patients with an AP in situ, 28 (53%) were Visick I, 11 (20%) were Visick II, 11 (20%) were Visick III, and 3 (7%) were Visick IV. We conclude that the AP has poor long-term results, with only 66% attaining Visick I and II, and a prosthesis removal rate of 15% (10/65). Patients with preoperative dysphagia, hypothyroidism, and diabetes tend to do worse with an AP. Obese patients and those with failed previous fundoplication seemed to fare well with an AP. In view of poor long-term results and high incidence of complications as compared to other conventional operations for GOR, we cannot recommend the continued use of the AP.

show abstract

Section: Discussionsupporting

confidence: 92%

Angelchik Prosthesis Revisited

et al. 2001

View full text Add to dashboard Cite

show abstract

“…In contradiction to our patient, the patient described had a normal postoperative period with normal oesophageal emptying seen on barium swallow following Belsey Mark IV antireflux J-tube. Overall, this fact highlights that transthoracic approach is a unique and excellent alternative to removal of AD when there are associated complications 15…”

Section: Discussionmentioning

confidence: 85%

“…Fewer reports, however, have demonstrated the removal of AD via a thoracotomy. Battaglini et al 15 described a case of a patient who developed severe, prolonged dysphagia following insertion of AD that caused angulation of the gastro-oesophageal junction with subsequent obstruction. A left posterolateral thoracotomy was performed, and the prosthesis was delivered through the hiatus.…”

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

View full text Add to dashboard Cite

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.

show abstract

“…Surgeons were still placing the Angelchik prosthesis, a C-shaped, silicone-filled device that was surgically secured around the lower esophagus, and it was considered a promising treatment for refractory patients [9]. Reports of complications had begun to appear and this device was later withdrawn from the market because of serious complications related to migration or erosion into the esophagus [10]. Open surgical fundoplication was performed for refractory patients and long-term results for fundoplication began to recognize that symptoms could recur long after initial surgery [11].…”

Section: Introductionmentioning

confidence: 99%

Developments in Gastroesophageal Reflux Disease over the Last 40 Years

Vakil

2023

Dig Dis

View full text Add to dashboard Cite

Background: The last 40 years have seen a remarkable change in our understanding of reflux disease. Summary: These changes encompass disease definition and impact, pathophysiology, diagnostic testing, regulatory oversight of clinical trials, pharmacotherapy, endoscopic, and surgical treatment. We have also seen a number of promising therapies fail. Key Messages: The future holds the promise of further advances. Adaptive artificial intelligence will take over diagnostics in manometry and pH impedance testing and patient-driven outcomes may be changed by interactions with artificial intelligence rather than humans. Changes in chip technology will allow higher resolution chips to be carried on smaller devices making extra-esophageal areas where reflux may play a role more accessible to prolonged observation and testing.

show abstract

Intractable Dysphagia Following Placement of Angelchik Prosthesis for Remix Esophagitis

Cited by 14 publications

References 0 publications

Angelchik Prosthesis Revisited

Angelchik Prosthesis Revisited

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

Developments in Gastroesophageal Reflux Disease over the Last 40 Years

Contact Info

Product

Resources

About