Bonavina L, DeMeester T, Mason R, Stein H J, Feussner H, Evander A
Department of Surgery, University of Milan, Italy.
Dis Esophagus. 1997 Apr;10(2):115-8. doi: 10.1093/dote/10.2.115.
The Angelchik prosthesis appears to be effective in preventing gastroesophageal reflux, although its precise mechanism of action remains controversial. In a unique in vitro model, 10 freshly harvested canine esophagogastric specimens were tested for their ability to remain competent against challenges of intragastric pressure under controlled conditions of intra-abdominal pressure, longitudinal esophageal tension, lower esophageal sphincter pressure and overall length and circumference of the cardia (measure of gastric dilatation). Competency of the specimen was assessed by stepwise variation in the overall length of the sphincter, while keeping constant intraabdominal pressure (20 cm H2O), intragastric pressure (20 cm H2O), esophageal tension (physiologic), lower esophageal sphincter pressure (15 cm H2O) and degree of gastric dilatation (3 cm). With each specimen serving as its own control, the effect produced by the application of an Angelchik prosthesis was evaluated. Results consistently demonstrated that at any lower esophageal sphincter length the percent of competency was increased when the prosthesis was applied (P < 0.01). The findings indicate that the Angelchik prosthesis controls reflux by preventing unfolding of the lower esophageal sphincter when challenged by intragastric pressure.
安吉尔奇克假体似乎在预防胃食管反流方面有效，尽管其确切作用机制仍存在争议。在一个独特的体外模型中，对10个新鲜采集的犬食管胃标本进行测试，观察它们在腹腔内压力、食管纵向张力、食管下括约肌压力以及贲门的总长度和周长（胃扩张程度的指标）等可控条件下，抵抗胃内压力挑战时保持功能正常的能力。通过逐步改变括约肌的总长度来评估标本的功能正常情况，同时保持腹腔内压力（20 cm H₂O）、胃内压力（20 cm H₂O）、食管张力（生理状态）、食管下括约肌压力（15 cm H₂O）和胃扩张程度（3 cm）恒定。以每个标本自身作为对照，评估应用安吉尔奇克假体产生的效果。结果一致表明，在任何食管下括约肌长度下，应用假体时功能正常的百分比都会增加（P < 0.01）。研究结果表明，安吉尔奇克假体通过在受到胃内压力挑战时防止食管下括约肌展开来控制反流。
