Complications of the Angelchik Antireflux Prosthesis

Benjamin, Stanley B.; Kerr, Robert G.; Cohen, David J.; Motaparthy, V.; Castell, Donald O.

doi:10.7326/0003-4819-100-4-570

Cited by 31 publications

(9 citation statements)

References 4 publications

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“…Our results certainly complement those presented recently by Gear et al and Angelchik et al [6,9]. The erosion of the prosthesis into the stomach or esophagus, as reported by a number of case studies and unreported personal communications, is a matter of special concern [10][11][12][13]. This potentially catastrophic complication has not occurred in our adult patients.…”

Section: Discussionsupporting

confidence: 89%

Assessment of the Angelchik prosthesis for treatment of symptomatic esophageal reflux

et al. 1987

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During a recent 5‐year period, 74 patients were fitted with an Angelchik antireflux prosthesis for symptomatic reflux esophagitis. Seventy‐five percent of 28 patients in the initial series (series 1) have had excellent to very good response to the prosthesis, as indicated by a clinical follow‐up of 36–60 mo. The main cause of failure in this series was prosthesis disruption (4 of 28 patients). Ninety‐two percent of 46 patients in the more recent series (series 2) have had excellent to very good response to prosthesis placement. The new prosthesis design, which includes a circumferential strap, has completely eliminated prosthesis disruption. Of the total series of patients, 19% of patients experienced transient dysphagia. This complication was no longer significant by 6 mo postoperatively, and no prostheses have had to be removed because of this complication. There have been no instances of erosion of the prosthesis. In addition to clinical data, lower esophageal sphincter measurements and recently, 24‐hr ambulatory pH monitoring have demonstrated a physiological effect of reflux protection after prosthesis placement. In our experience, the Angelchik prosthesis has been especially useful in high‐risk patients, patients who have recurrent esophagitis after previous antireflux or foregut surgery, and patients who would probably not have been referred for conventional antireflux surgery. In view of our data, we believe that the Angelchik prosthesis should continue to be commercially available as a surgical option for treating selected patients with medically refractory reflux esophagitis.

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Section: Discussionsupporting

confidence: 89%

Assessment of the Angelchik prosthesis for treatment of symptomatic esophageal reflux

et al. 1987

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“…In addition, a dense fibrotic capsule has been described surrounding the implanted prostheses, which appears to contribute to dysphagia. There are 22 cases that describe severe erosion of the Angelchik prosthesis into the esophageal or gastric lumen [26,[28][29][30][31][32][33][34][35].…”

Section: Discussionmentioning

confidence: 99%

Mesh complications after prosthetic reinforcement of hiatal closure: a 28-case series

et al. 2008

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“…For example, the event was reported with some frequency after the Angelchik prosthesis became popular some 30 years ago. [21][22][23][24] Even Teflon pledgets have been reported to cause similar complications such as erosion into the fundus and the induction of fibrous retraction and dysphagia. 7 To date, there have been three erosive complications reported in association with the use of PTFE as a prosthesis for crural closure.…”

Section: Erosionmentioning

confidence: 99%

Complications of PTFE Mesh at the Diaphragmatic Hiatus

Tatum

Shalhub

Oelschlager

et al. 2008

Journal of Gastrointestinal Surgery

129

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Paraesophageal hernia repair has been associated with a recurrence rate of up to 42%. Thus, in the last decade, there has been increasing interest in the use of mesh reinforcement of the hiatal repair. Polytetrafluoroethylene (PTFE) is one of the materials that have been used for this purpose, as it is thought to induce minimal tissue reaction. We report two cases in which complications specific to the use of PTFE mesh in this location developed over time. In the first patient, a gastrectomy was required to remove a large PTFE mesh which had eroded into the esophagogastric junction and gastric cardia. The second patient experienced severe dysphagia resulting from a stricture caused by the implant, requiring removal of the mesh. Although such complications have only rarely been reported, the severity and consequences of these incidents, as reported in the literature and in light of our observations, suggest that an alternative to PTFE should be considered for crural reinforcement during paraesophageal hernia repair.

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Complications of the Angelchik Antireflux Prosthesis

Cited by 31 publications

References 4 publications

Assessment of the Angelchik prosthesis for treatment of symptomatic esophageal reflux

Assessment of the Angelchik prosthesis for treatment of symptomatic esophageal reflux

Mesh complications after prosthetic reinforcement of hiatal closure: a 28-case series

Complications of PTFE Mesh at the Diaphragmatic Hiatus

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