Laparoscopic versus open elective right hemicolectomy with curative intent for colon adenocarcinoma.

INTRODUCTION: Even today, at a time of full development of laparoscopy, a comparison with classical open surgery is important. The aim of the study was to compare retrospectively short-term perioperative and early postoperative outcomes between laparoscopic (LRH) and open (ORH) right hemicolectomy in the colorectal cancer treatment. METHODS: A retrospective analysis followed 57 patients, regardless of age or gender, who underwent elective right-sided hemicolectomy due to the right colon adenocarcinoma over a period of 2 years. The study compares the laparoscopic and classical methods based on perioperative and early postoperative results. RESULTS: In almost none of the monitored data we found a statistically significant difference between LRH and ORH. The length of the operation was 128min at ORH, 150 min at LRH, the percentage of converted LRH was 16.7%. A statistically significant difference was found in the blood loss amount, LRH 74±106 ml vs ORH 159±96ml p0.05. The average length of postoperative hospitalization was 7.2 days for LRH, 8.1 days for ORH. The comprehensive complication index was 8.9 in laparoscopy, 17.8 in the conventional method. CONCLUSION: The results at our workplace suggest that laparoscopic and open right hemicolectomy were equivalent at the time, in terms of the observed data. Nevertheless, we cannot ignore that most of the data suggest a benefit of laparoscopy over the conventional method.

MYOSTIM-FES to prevent muscle atrophy in microgravity and bed rest: preliminary report.

Long-term flights in microgravity cause atrophy and morphological changes of skeletal muscles. Training with mechanical devices is insufficient regarding the required time to exercise and space for devices. The objective of this project is to develop a passive training method based on functional electrostimulation (FES) to preserve muscle mass and fiber composition with minimal impairment to the cosmonaut. For a pilot experiment on the MIR space station, a suitable 8 channel FES device was developed. It consists of electrode trousers that carry surface electrodes and cables, 2 interconnected 4 channel stimulators, and a laptop personal computer (PC) for stimulator programming and processing compliance data. An automatic extensive training of 4 muscle groups of the lower extremities is performed for 6 h/day, with 1 s on and 2 s off tetanic contractions at 20-30% of maximum tetanic muscle force. The synchronous activation of antagonists of the thigh and lower leg prevents uncoordinated movements.

Electromyogram-controlled functional electrical stimulation for treatment of the paralyzed upper extremity.

Spinal cord lesions at level C5 to C6 lead to loss of hand functions and lesions at C4 to additional deficits of arm functionality. The presented dual channel surface stimulator with dual channel electromyogram (EMG) measurement was developed to investigate control strategies for an EMG-controlled implantable stimulation system and serves in addition as a therapy device for patients with partial innervation but weak muscle force. Four different control strategies for stimulation amplitude are available. The amplitude can be preset manually or can follow the preprocessed EMG signals proportionally. The shoulder control program allows proportional control of both stimulation channels with one EMG channel while the second EMG channel serves as the channel selector. Finally, a special feedback training program triggers a stimulation burst when EMG activity is detected. During a 2 year patient study, 18 patients from 2 hospitals and 1 rehabilitation center performed the feedback training. Almost all patients obtained an improvement of functionality. Apart from muscle strengthening, the feedback effect led to an improvement of proprioception and supported relearning of motions. For the documentation of the training status, functional muscle test (British Medical Research Council) and measurements of power, angle, torque, muscle fatigue, and EMG were performed. Obviously, EMG triggered stimulation provides several advantages compared to conventional passive electrical stimulation.