Appraisal of the Angelchik anti-reflux prosthesis based on clinical and manometric data and pH monitoring.

Data are presented from manometric and prolonged pH monitoring studies in 11 patients in whom the Angelchik anti-reflux prosthesis was inserted for control of symptomatic gastro-oesophageal reflux. Symptomatic and objective improvement was seen in the majority of our patients, although three suffered major side effects (erosion of prosthesis into the stomach in two, severe dysphagia in one). Impaired lower oesophageal sphincter relaxation noted after operation may explain both the transient dysphagia observed in five patients and the reduction in reflux episodes. Improvement in oesophageal acid clearance may result from fixation of the oesophagus within the abdomen by the device. While continued use of the prosthesis should be viewed with caution, it is effective and may have a place in the management of selected patients.