Mechanical effect of the Angelchik prosthesis on the competency of the gastric cardia: pathophysiologic implications and surgical perspectives

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
L BonavinaA Evander

Abstract

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 th...Continue Reading

Citations

Jun 17, 1999·International Journal of Cancer. Journal International Du Cancer·M SagaraE Sato
Jul 1, 2009·Obesity Reviews : an Official Journal of the International Association for the Study of Obesity·J R de JongA J P M Smout
Jun 10, 2011·Expert Review of Gastroenterology & Hepatology·Ines GockelBlair A Jobe
Dec 18, 2015·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·L Bonavina, S Attwood
Oct 15, 2013·Annals of the New York Academy of Sciences·Luigi BonavinaEelco Wassenaar
Mar 20, 2014·Scandinavian Journal of Gastroenterology·Jung Youn MoonGeun Am Song
Apr 17, 2015·Surgical Endoscopy·Margit BauerHubertus Feussner
Oct 11, 2008·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Luigi BonavinaTom DeMeester

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