Intrathoracic esophageal perforation with the Angelchik antireflux prosthesis: Report of a new complication

Albin, Jorge; Allan, TN; Khalil, Kamal

doi:10.1007/bf01893123

Cited by 13 publications

(3 citation statements)

References 5 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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“…This fact required the removal of the prosthesis in some cases[ 36 , 42 ] and was also responsible for some other more severe complications. In fact, a continuous compression of the plastic collar, leaning on the esophageal wall, in some cases also caused erosions, fistulas and perforations of the esophagus and stomach, that sometimes were followed by migration of the device into the gastric lumen[ 43 - 48 ]. These complications began to appear years after insertion of the prosthesis, but despite this, it continued to be implanted for years.…”

Section: The Msa Devicementioning

confidence: 99%

Magnetic challenge against gastroesophageal reflux

Bortolotti¹

2021

WJG

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Almost 15 years have passed since the first paper on the possibility of using magnets to prevent gastro-esophageal reflux (GER) was published and so it is time to assess the results obtained with the first magnetic device available on the market, the Linx magnetic sphincter augmentation (MSA) and to consider what other options are forthcoming. MSA demonstrated an anti-reflux activity similar to that of Nissen fundoplication, considered the “gold standard” surgical treatment for GER disease, and caused less gas-bloating and a better ability to allow vomiting and belching. However, unlike Nissen fundoplication, this magnetic device is burdened by complications, which are roughly similar to those of the non-magnetic anti-reflux Angelchik prosthesis, that, after considerable use in the eighties, was shelved due to these complications. It is interesting to note that some of these complications show the same pathophysiological mechanism in both devices. The upcoming new magnetic devices should avoid these complications, as their anti-reflux magnetic mechanism is completely different. The experiments in animals regarding these new magnetic appliances were examined, remarking their advantages and drawbacks, but the way to apply them in surgical practice is long and difficult, although worthy, as they represent the future of magnetic surgery.

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“…This could be explained by the fact that the magnetic device became encapsulated in fibrous tissue, as observed in a porcine model study [7], that likely impaired the approaching of magnets, transforming the "magnetic collar" to a sort of Angelchik prosthesis made of metal covered by connective tissue. These similarities of the "magnetic collar" with Angelchik prosthesis could raise the fear that the "magnetic collar" too could incur similar complications, as slipping on the stomach or into the thoracic cavity, migration in the abdominal cavity, erosion of the gastroesophageal tissues with perforation of esophagus or penetration into the gastric cavity [4][5][6]8,9].…”

Section: To the Editormentioning

confidence: 99%

The “magnetic collar”: the ultimate solution for gastroesophageal reflux?

Bortolotti

2014

Scandinavian Journal of Gastroenterology

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Intrathoracic esophageal perforation with the Angelchik antireflux prosthesis: Report of a new complication

Cited by 13 publications

References 5 publications

Assessment of the Angelchik prosthesis for treatment of symptomatic esophageal reflux

Assessment of the Angelchik prosthesis for treatment of symptomatic esophageal reflux

Magnetic challenge against gastroesophageal reflux

The “magnetic collar”: the ultimate solution for gastroesophageal reflux?

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