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Achalasia.

M Ayoubi1, L Framarin, E Solerio

  • 1Division of Gastroenterology and Hepatology, Gradenigo Hospital, Turin, Italy. ayoubi@libero.it

Minerva Gastroenterologica E Dietologica
|February 18, 2006
PubMed
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The Starck procedure for achalasia is effective and safe in experienced hands, despite being largely replaced by newer methods. This study evaluated its historical safety and outcomes for esophageal achalasia treatment.

Area of Science:

  • Gastroenterology
  • Esophageal Motility Disorders
  • Surgical History

Background:

  • Achalasia, a disorder of the esophageal Auerbach submucous plexus, causes dysphagia and chest pain due to impaired cardia relaxation.
  • Historically, the Starck apparatus was a primary treatment for achalasia, but it had a high perforation rate, leading to its replacement by balloon dilators.
  • This study revisits the safety and efficacy of the Starck procedure.

Purpose of the Study:

  • To evaluate the safety, early, and late results of the Starck procedure for treating esophageal achalasia.
  • To assess the effectiveness of the Starck procedure using the Vantrappen and Hellemans scale.

Main Methods:

  • Retrospective analysis of 21 patients with esophageal achalasia who underwent 52 Starck procedures.

Related Experiment Videos

  • Patients' outcomes were assessed based on established effectiveness scales.

    • Main Results:

    • Excellent results were observed in 50% of patients, good results in 40%, and poor results in 10% after two Starck sessions.
    • One patient (5%) experienced manageable gastroesophageal reflux post-procedure.
    • No major complications were reported during or after the dilations.

    Conclusions:

    • The Starck procedure demonstrated effectiveness and safety when performed by experienced practitioners.
    • Although largely superseded by modern dilators like Rigiflex, the Starck procedure's historical efficacy is confirmed.
    • This study provides valuable insights into the long-term outcomes of a historically significant achalasia treatment.