Biomedical subjects

K Werkmäster

Publications and source records attributed to K Werkmäster.

6 recordsLinked to original sources

PubMed1988

Management of esophageal atresia: review of 16 years' experience.

This report reviews 16 years' experience in the management of patients with esophageal atresia (EA) and tracheoesophageal fistula (TEF), with special emphasis on long-term results and early complications in relation to the magnitude of the gap between the esophageal segments. In 94 infants with no or moderate distance between the esophageal ends (less than 2 cm), an end-to-end anastomosis was performed in 90 cases after closing the TEF. In 51 of the 90 patients, no complications were seen (57%), whereas in the remaining 39, postoperative complications were noted with anastomotic leakage (24 patients, 26%), anastomotic stricture (16 patients, 18%) and gastroesophageal reflux (5 patients, 5%). Sixteen patients (9 with and 7 without TEF) had a "long gap" between the esophageal segments (greater than 2 cm). Thirteen (9 with and 4 without TEF) of these 16 patients were subjected to an end-to-end anastomosis, 11 primarily and two secondarily after 3 and 12 weeks, respectively. All 13 patients with an end-to-end anastomosis had anastomotic leakage (100%)--nine had stricture (75%) and 5 had gastroesophageal reflux (50%). The remaining three patients in this long-gap group were subjected to colon transposition, two primarily and one secondarily. The total mortality rate decreased from 19/57 patients (33%) from 1969 to 1977, to 5/53 (9%) from 1978 to 1984. The main cause of death in both periods was associated anomalies (18% and 7%, respectively), whereas deaths related to the EA malformation as such had almost disappeared during the latter period (15% and 2%, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Esophageal Atresia↗

PubMed1986

Management of long-gap esophagus: experience with end-to-end anastomosis under maximal tension.

From 1969 to 1982, 15 cases of long-gap esophageal atresia were treated. Twelve patients could be managed by direct end-to-end anastomosis - ten primary and two delayed. Anastomotic leakage was noted in all patients, causing anastomotic obstruction in nine, which had to be treated with repeated esophageal dilatations. In one patient the esophageal dilatation resulted in esophageal perforation, with a fatal outcome. The remaining 11 patients are all doing well. Three patients were subjected to colonic transposition, two primary and one delayed according to Waterston. One of these subjected to primary colonic transposition died postoperatively from cerebral hemorrhage. The other one is now doing well after resection of the transposed colonic segment which fibrotized but could be resected, after which the esophageal ends could be anastomosed. The patient subjected to delayed colon transposition is also free of major swallowing problems following immediate postoperative anastomotic stricture which could be managed by repeated dilatations.

Colon↗

PubMed1979

Postoperative causes of death in pediatric surgery: analysis and conclusions for the therapy.

The mortality of children with posterolateral diaphragmatic hernia (PDH) is mainly dependent upon the degree of lung hypoplasia. Other less significant factors are dysmaturity, associated anomalies, infection and haemorrhages. Children with grave cyanosis from PDH immediately after birth have a poor prognosis due to persistent foetal circulation with pulmonary vascular hypertension and right-left shunting. A better understanding and treatment of this persistent foetal circulation may considerably improve the surgical mortality, though in some cases the lung hypoplasia may be too far advanced.

Ductus Arteriosus, Patent↗

PubMed1979

[Experiences about ductus arteriosus closure with congenital diaphragmatic hernia (author's transl)].

Ten cases of posterolateral diaphragmatic hernia have been operated upon the last two years. Three cases of these have successfully been operated in conventional way. In seven cases ductus arteriosus was closed. Only two cases survived. A preoperative evaluation is to be done. Depending on the blood-gas-analysis, the cases can be divided into cases belonging to the survival zone and cases belonging to the fatal zone according to Boix-Ochoa. If it is possible to increase the oxygen uptake and to expire the carbonic acid, the results seem to be good after conventional operation. If it not will be possible to increase the oxygen saturation and not even possible to reduce the CO2 pressure with a ventilator with 100 per cent oxygen, the cases are to be considered inoperable. In fatal zone cases, where a reduction of PCO2 is possible, but there are no possibilities to get an increased oxygen saturation, an operative closing of ductus can be tried if heart anoxia is treated with the aid of an oxygenator.

Carbon Dioxide↗

PubMed1977

[Siamese twins].

Explore the source record for details and available documents.

Heart Defects, Congenital↗

PubMed1977

Posterolateral diaphragmatic hernia--long-term results.

During the years 1965--1974, 125 cases of posterolateral diaphragmatic hernia have been operated at five departments of pediatric surgery in Sweden. The overall operative mortality was 50%. A follow-up investigation included 19 cases, where in 12 cases spirometry and in 11 cases studies of the mobility of the diaphragm were included. Physical examination revealed excellent results in most cases. Lung function studies, however, show a moderate (20--30%) reduction, which is not surprising with regard to lung hypoplasia and impaired movement of the diaphragm on the operated side. In adolescence and younger age, these patients are mostly in excellent condition; but later, when lung function is also reduced by the age factor, their neonatal condition may be of importance.

Adolescent↗