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Ann Thorac Surg 1994;57:1557-1558
© 1994 The Society of Thoracic Surgeons

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Articles

Reoperation for complications of the Angelchik antireflux prosthesis

Department of Surgery, Royal Alexandra Hospital, Edmonton, Alberta, Canada

Accepted for publication October 13, 1993.

^_* Address reprint requests to Dr Urschel, Division of Thoracic Surgery, Roswell Park Cancer Institute, Elm and Carlton Sts, Buffalo, NY 14263-0001.

The Angelchik antireflux prosthesis is associated with complications that require reoperation in 5% to 15% of patients. To determine the morbidity and success of reoperation for these complications, we conducted a retrospective study of 15 patients. Time to reoperation ranged from 3 weeks to 113 months with a mean of 31 months. Indications for reoperation included dysphagia (8 patients), recurrent reflux (6 patients), and prosthesis migration (1 patient). Ten patients underwent prosthesis removal and fundoplication, 4 had prosthesis removal without fundoplication, and 1 patient had the prosthesis repositioned. latrogenic splenic injury occurred in 2 patients (13%); one splencctomy and one splenic repair were done. Four patients (27%) required intraoperative blood transfusion. There were no operative deaths. Removal of the prosthesis without fundoplication resulted in a significantly higher incidence of recurrent reflux (75%) than prosthesis removal and fundoplication (10%) (p < 0.04). Although reoperation for complications of the Angelchik antireflux prosthesis can be technically difficult, morbidity and mortality are acceptable. An antireflux procedure should be done at the time of prosthesis removal.

This article has been cited by other articles:

				P. F. Crookes and T. R. DeMeester The Angelchik prosthesis: What have we learned in fifteen years? Ann. Thorac. Surg., June 1, 1994; 57(6): 1385 - 1386. [PDF]