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Biomedical subjects

W C Hecker

Publications and source records attributed to W C Hecker.

At least 73 records · Page 4Linked to original sources
PubMed1983

Infrared-contact coagulation of parenchymatous organs - report of three cases.

Infrared-contact coagulation of the spleen with an infrared-sapphire-coagulator was applied in two children with subcapsular hematoma and splenic cyst, thereby achieving complete and partial organ preservation, respectively. This method was also used for haemostasis following the dissection of a common liver in Siamese twins. Infrared-contact coagulation is a proper method for organ preservation in injuries or other pathological conditions of parenchymatous organs.

Child↗
PubMed1983

Thyroid carcinoma in childhood.

About 50% of children with thyroid carcinoma present with regional lymph node metastases as the leading symptom. The "cold nodule" is the typical scintigraphic finding in thyroid cancer in infants. Papillary carcinoma is the predominating histologic type (80%) and has a good prognosis. Radical removal of the thyroid lobe with the primary lesion and subtotal resection of the opposite lobe, combined with selective neck dissection if necessary, seems to improve the results. Postoperative scintigraphic examinations detect remnants of malignant tissue requiring 131-iodine treatment and, finally, TSH-suppressive hormone is administered. In our own cases, the survival rate in 25 children was over 90%.

Adenocarcinoma↗
PubMed1982

[Ambulatory surgery procedures in childhood].

Outpatient surgery is emotionally and psychologically ideal for children and does not involve an increased risk factor. New contracts to cover costs must be made between hospital representatives and health insurance companies in order to make outpatient surgery possible. In accordance with the increased demands of outpatient surgery, the hospital representative must provide adequate personnel and a suitable budget. The medical councils must modify their rules on further training, that is, they must turn away from the automatic hospitalization concept ("Bettenschlüssel"), so that outpatient surgery can develop.

Age Factors↗
PubMed1982

[Timing and technic of the surgical correction of childhood intersex genitals including the procedure for partial vaginal aplasia].

The author holds the opinion that surgical correction of intersexual outer genital should be performed before the second birthday. In case of an adrenogenital syndrome with deep (peripheral) junction of the vagina into the urogenital sinus, vaginoplasty of the introitus and displacement of the clitoris should be performed in a single session. The author describes his own operational technique. If the vagina enters the urogenital sinus near the bladder, the author recommends to employ the operation technique described by Hendrin for removal and reimplantation of the vagina into the perineum, combined with the author's own technique of displacing the clitoris. Partial absence or atrophy of the vagina was seen in 8 cases. The author describes his own abdominoperineal operation method for correcting this defect. In cases where the intersexual genital is to be corrected in the direction of a male genital, the author recommends shaft erection in the first session and urethroplasty in the second session according to the technique described by Denis Browne. In all, 132 patients were surgically treated for correction of an intersexual genital.

Child↗
PubMed1982

[Indication for operation and results in cardia insufficiency with or without hiatic hernia in childhood (author's transl)].

After discussing the problems in cardia insufficiency in childhood it is suggested that conservative treatment is indicated in minor-oesophageal refluxes, most medium-range refluxes and hiatic hernias of minor degree. Surgical treatment is indicated if conservative therapy over 4 weeks is ineffective. Still and absolute indication for operation must be distinguished from a relative indication. Absolute indications are: oesophagitis, oesophageal stricture, Roviralta's-syndrome, major refluxes, some medium-range refluxes as well as all hiatic hernias except minor forms in young infants. Relative indications are: refluxes accompanied by cyanotic attacks possibly leading to sudden infant death, recurrent pneumonias or rumination. Mortality was 2,3% in all 211 patients and zero during the last 10 years. In 98% of 160 patients who were reexamined, satisfactory results were achieved. Recurrencies occurred only following thoracic operations formerly in use, whereas today operations for cardia insufficiency are exclusively abdominal.

Cardia↗
PubMed1981

Reverse smooth muscle plasty: a new method of treating anorectal incontinence in infants with high anal and rectal atresia.

A new technique of treating anorectal incontinence in infants with high anal and rectal atresia is described. In the first stage of this new operation an abdominosacroperineal pull-through procedure according to Rehbein, Romualdi, and Kiesewetter is performed. In the next step of this new method the circular and longitudinal muscle layers of the pulled-through colon are turned back 180 degree and fixed to the pulled-through bowel. The mucosa of the turned back bowel is removed. Then the whole muscle cuff is re-pulled into the puborectalis sling. Pressure studies as well as X-ray investigations showed a good sphincter function of the newly established internal sphincter equivalent.

Anal Canal↗
PubMed1981

[Non-union of the testicle with the epididymis in undescended testis (author's transl)].

A 9-year-old boy is presented in whom an undescended testicle was found at orchidopexy to be totally separated from a descended epididymis. The problem of non-fusion between epididymis and testis is discussed. It is recommended that if only epididymis and vas are found in the scrotum a full exploration for undescended testicle should still be carried out.

Child↗
PubMed1981

[Flapped and free muscle transplantation in the treatment of anal incontinence (author's transl)].

49 patients with continence-improving operations were reviewed. 41 children underwent a gracilis-transplantation according to Pickrell, 6 patients a free muscle transplantation according to Hakelius/Grotte and 2 patients a smooth muscle graft according to Schmidt. The clinical and manometrical results were compared with data from the literature. Furthermore a new technique of smooth muscle transplantation in the young infant is described. During an abdomino-sacroperineal pull-through procedure a flapped smooth muscle transplantation is performed simultaneously. The circular and longitudinal muscle layer of the pulled-through colon will be turned back and is fixed on the serosa under light tension. Afterwards the whole muscle cuff is repulled into the puborectalis sling. Examinations of the anorectal pressure as well as X-ray investigations showed a good function of the newly-established internal anal sphincter equivalent.

Adolescent↗
PubMed1981

[Operative procedure in choledochal cysts (author's transl)].

Case-description of a large cyst of the bile duct in a 10-year-old girl. The cyst extended from the distal part of the common hepatic duct almost to the duodenum. The pancreatic and bile ducts drained the cyst distally with a common outlet. The cyst was resected, except for a small preduodenal remnant. The remaining part was closed to form a hood, and implanted end-to-side into a loop of small bowel which had been diverted by Roux's method. The common hepatic duct was also anastomosed end-to-side with the same diverted loop of bowel.

Child↗
PubMed1981

[Oesophageal atresia type Vogt IIIB with fistula of the distal segment to the cervical trachea, combined with right descending aorta and further malformations (author's transl)].

Presentation of a hitherto unreported variation of oesophageal atresia in a male infant. There was a blind end to the upper segment, the lower was joined to the cervical trachea by a fistula. Both segments were surrounded by a muscle sheath. In addition, the patient demonstrated a right descending aorta. Since the fistula was situated unexpectedly high, it was necessary to approach through a cervical incision, both a right- and left-thoracotomy having proved useless. The fistula was divided, and the oesophageal ends joined. The child also suffered from congenital deformities of the heart and the spine. The authors recommend preoperative tracheaoscopy to determine the site of the fistula, and hard ray exposure X-ray of the chest, showing the course of the aorta.

Abnormalities, Multiple↗
PubMed1981

[Results of operative correction of pigeon and funnel chest following a modified procedure of Ravitch and Haller (author's transl)].

A surgical technique which is a modification of the technique described by Ravitch is presented in detail. We employed it in 441 patients, among them 85% with funnel chest, 11% with pigeon breast and 4% with combined funnel-pigeon breast. The pre- and postoperative measurement of the chest deformity which provides an objective evaluation of the surgical result is described. The postoperative results were in 91% satisfactory and in only 9% unsatisfactory. No postoperative death was observed in the last 420 patients. The overall mortality in the world literature is 0,05%.

Anthropometry↗