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Biomedical subjects

W C Hecker

Publications and source records attributed to W C Hecker.

At least 19 recordsLinked to original sources
PubMed1991

Tracheal stenosis by innominate artery compression in infants: surgical treatment in 35 cases.

This is a report on 35 cases of innominate artery compression of the trachea and its surgical correction by means of aortotruncopexy. Diagnostic procedures of choice were tracheoscopy and magnetic resonance imaging, which offers representative images of inspiration and expiration, shows the anatomical relations between aortic arch and trachea and reveals the extent of tracheal compression. Surgical treatment is indicated if narrowing of the tracheal lumen exceeds 70%. By fixation of the aortic arch and the proximal innominate artery to the back of the sternum, tracheal compression is relieved. There was no unsuccessful operation in the 35 children. One late death occurred from cardiac failure, unrelated to tracheal compression.

Aorta, Thoracic↗
PubMed1991

Indication and results of thoracic surgical procedures in premature infants.

This analysis concerns three groups of malformations: Congenital diaphragmatic hernia, patent ductus arteriosus, and oesophageal atresia. We registered a total mortality rate for all congenital diaphragmatic hernias and defects of 28.5%; the rate in full-term neonates was 27.6% and in premature infants 33.6%. Of 65 infants with a patent ductus arteriosus and a birth weight less than 1500 g, 14 died (21.5%). In most cases death was caused by sepsis. Among the 159 patients with oesophageal atresia who were treated in our hospital, 58 were premature infants. During the last 20 years, the total mortality rate among our patients was 28.9%. We had a mortality rate of 44.8% in premature infants and of 19.8% in full-term neonates. An analysis of the last 10 years showed a survival rate of 97% in healthy infants (group A in Waterston's classification). In group C, the most disadvantageous group (premature infants, severe anomalies), the rate was 61%.

Ductus Arteriosus, Patent↗
PubMed1991

Surgery for benign and malignant diseases of the thyroid gland in childhood.

From 1970 to 1986, 51 children and adolescents aged 5-18 years were operated on for diseases of the thyroid gland, among them 42 with benign diseases (juvenile goiter 21, adenoma 17, Graves' disease 3, Hashimoto's thyroiditis 1) and nine with malignancies (papillary carcinoma 4, follicular carcinoma 3, medullary carcinoma 1, anaplastic carcinoma 1). In benign entities, females were three times as often affected as males, whereas both sexes were equally affected in malignancies. Positive family histories were found in 23.3% of the children with adenomas in 71.4% of the children with juvenile goiters. Subtotal strumectomy was carried out in 30 instances and enucleation in 12. Iodized salt and L-thyroxine were given postoperatively as recurrence prophylaxis. Recurrence was seen in two children (4.8%) who had no recurrence prophylaxis. Symptoms in children with malignancies were palpable cervical lymph nodes and solitary nodes in the thyroid gland. Total thyroidectomy was done in all instances, followed by radio-iodine treatment in eight cases and cobalt 60 irradiation in one case. Two children died, of diffuse metastases and irradiation fibrosis of the lung respectively. The peculiarities of diseases of the thyroid gland in childhood that require surgery are discussed.

Adenocarcinoma↗
PubMed1991

Ileus in the newborn: a study of decreasing mortality.

The authors' experience with operative therapy for ileus-duodenal, small intestinal, colon, and rectal-in newborns is presented with an analysis of the improvements in prognosis over the last 30 years. For the time period 1980-1989, the following survival rates were achieved: duodenum: 100%; small bowel: overall 96.8%, for uncomplicated cases 100%; congenital megacolon: overall 89%, for uncomplicated cases 100%; ileus of all intestinal portions together: 97.5%, for uncomplicated cases 100%.

Anastomosis, Surgical↗
PubMed1991

Clinical findings in middle lobe syndrome and other processes of pulmonary shrinkage in children (atelectasis syndrome).

Processes of atelectasis and pulmonary shrinkage are not confined to the right middle lobe. This fact is illustrated by case reports of five of our nine such patients. All cases shared common clinical and morphologic similarities: congenital malformations of the bronchial skeleton, compression, and chronic inflammation produce comparable pulmonary morphology that always includes atelectasis. Atelectasic processes of longer duration require surgical resection; this led to cures in all the authors' patients.

Bronchiectasis↗
PubMed1991

[Surgical therapy of neonatal necrotizing enterocolitis].

Between 1972 and 1988, a total of 57 patients with an average birth weight of 1988 g and an average gestational age of 34.1 weeks were operated on for neonatal necrotizing enterocolitis. In 48% of the cases, the critical indication for surgery was determined by clinical examination; in 52% of the cases, the indication was based upon a radiological diagnosis of pneumoperitoneum. The affected intestinal portions were first resected. Then, the proximal and distal limbs were sewn together and brought out through a separate short incision. Utilizing this procedure, the lethal rate sank from above 80% to below 30%. Taking into account unrelated causes of death, no significant increase in risk has been associated with the use of this procedure on prematurely born patients and patients exhibiting acute intestinal perforations.

Birth Weight↗
PubMed1990

Deviated trachea in hypoplasia and aplasia of the right lung: airway obstruction and its release by aortopexy.

Three cases of male infants with hypoplasia and aplasia of the right lung and dextrocardia are reported. The infants developed increasing obstructive respiratory distress in the first 4 months of life. In all three cases, there was an opaque right hemithorax with overinflation of the left lung, a posterior deviation of the trachea with pulsatile stenosis, and a posteriorly located aortic arch. Hypoplasia (two cases) or aplasia (one case) of the right pulmonary artery and an absence or a remnant of the right main bronchus were also observed. Associated malformations were esophageal atresia with an abnormal high pouch of the proximal esophagus in case 1, and hypertelorismus syndrome in case 2. Because of severe respiratory distress in all three patients, an aortopexy was performed at the ages of 5 months (one infant) and 10 months (two infants). The obstructive respiratory signs disappeared postoperatively in the following weeks. It has been observed that tracheal stenosis in aplasia or hypoplasia of the right lung may be caused by the dislocated aortic arch. An aortopexy can release the airway compression in such cases. Because of associated malformations, a careful evaluation of the airway and vessels is recommended.

Airway Obstruction↗
PubMed1990

[Tracheal compression by the brachiocephalic trunk in infants--surgical treatment of 30 cases].

This is a report on 30 cases of innominate artery compression of the trachea and its operative correction by an aorto-truncopexy. Tracheoscopy is the most important examination for arriving at the diagnosis. Magnetic resonance imaging (MRI), which offers representative pictures of many moments of expiration and inspiration, shows the anatomic relationship between the innominate artery, the aortic arch and the trachea, also demonstrating the extent of the tracheal compression. Surgical treatment is indicated if narrowing of the lumen of the trachea is greater than 70%. By fixing the aortic arch and the proximal innominate artery at the back of the sternum the trachea is relieved of its compression. In 30 children there was no unsuccessful operation, and none of them died.

Aorta, Thoracic↗
PubMed1989

[Quality of life after surgical interventions in pediatrics].

Quality of life is a complex entity without "normal finding" and can be judged by objective and subjective criteria. Quality of life of a child results out of the main factors which are connected to each other and represent the actual specific profile of a personality. The disease or dysplasia itself, personality of the patient, personality of the attending physician as well as of the parents. Quality of life of a child consists of five interwoven spheres: bodily function of the child; psychological well-being; social interactions; physical state; and parents.

Activities of Daily Living↗
PubMed1989

[Appendicitis in enteritis].

We are confronted with the fact that in a considerable number of cases appendicitis occurring during enteritis is diagnosed late and is often only operated on in the state of perforation. Among our own cases of 519 appendectomies in the last five-years-period this applied to 13 children (2.4%). The problems of these cases and methods to a correct and immediate diagnosis are shown.

Adolescent↗
PubMed1988

[Primary liver tumors in childhood: an analysis of 19 cases].

Nineteen patients were operated on for primary liver tumors at our hospital from 1970 to March 1987. Among malignancies, hepatoblastomas and hepatocellular carcinomas were equally often seen (7 cases each), among benign tumors, there were 3 hemangioendotheliomas and 2 hemangiomas. In 6 of the 14 children with malignant tumors, only a biopsy could be performed due to primary inoperability, tumor excision was possible in 8 cases. Following chemo-embolisation, tumor excision could be carried out in a second-look operation in one case. Six patients with hepatoblastoma died within 6 months following diagnosis, 2 of them, however, succumbed to therapeutical side effects. Four of the seven patients with hepatocellular carcinoma were alive after a mean follow-up of 6.4 years (2-15 years).

Adolescent↗