[Laparoscopic surgery for malignancies of the colon, rectum, and anus in Lithuania in 2008].
THE OBJECTIVE OF THIS STUDY: was to analyze data on laparoscopic surgery for malignant diseases of the colon, rectum, and anus in Lithuania during the period of January 1, 2005, to February 15, 2008.


METHODS
During the above-mentioned period in Lithuania, 130 laparoscopic surgeries for malignancies of colon, rectum, and anus were performed in seven different hospitals. There were 73 males and 57 females with a mean age of 68 years (range, 35-85 years). Laparoscopic procedures were attempted in 140 cases. Out of them, 130 were completed laparoscopically; 10 operations were converted to open, and conversion rate was 7.1%. Twenty-seven (20.8%) patients had stage I, 45 (34.6%) stage II, 45 (34.6%) stage III, and 13 (10%) stage IV disease. Ninety-two (70.8%) patients underwent straight laparoscopic surgery and 38 (29.2%) - hand-assisted laparoscopic surgery. Time in surgery was from 50 to 365 min, with a mean of 183 min. During 130 operations, in 11 (8.5%) cases, blood vessels were ligated through specimen retrieval site. Out of 104 operations, where anastomosis was performed (23 abdominoperineal resections and 3 Hartmann's procedures), in 68 (65.4%) cases it was done laparoscopically and in 36 (34.6%) cases using conventional extracorporal suturing.


RESULTS
Hospital stay ranged from 7 to 59 days, with a mean of 12 days. One (0.8%) patient died. Postoperative complications occurred in 27 (20.8%) cases. Reoperation rate was 4.6% (6 cases). Complications were as follows: suture insufficiency (3 cases), eventration (3 cases), wound infection (7 cases), intraperitoneal abscess (1 case), abdominal wall phlegmon (1 case), intra-abdominal infiltrate (1 case), perineal hematoma (1 case), proctovaginal fistula (2 case), intraoperative bleeding from uterus (1 case), urinary retention (4 cases), cystitis (1 case), pneumonia (1 case), acute cardiovascular insufficiently (1 case). In histological specimens, 10 lymph nodes were found on the average (range, 2 to 27).


CONCLUSIONS
Laparoscopic surgery for malignant diseases of the colon, rectum, and anus is dominating among laparoscopic surgeries for colorectum. Complication rate is similar to other authors. To evaluate disease relapse and outcomes, observation time is not sufficient yet.
Samalavicius
Narimantas Evaldas
NE
Institute of Oncology, Vilnius University, Santariskiu 1, 08406 Vilnius, Lithuania. narimantsam@takas.lt
Rudinskaite
Giedre
G
Pavalkis
Dainius
D
Latkauskas
Tadas
T
Kaselis
Nerijus
N
Sidlauskas
Zilvinas
Z
Sniuolis
Pranas
P
Poskus
Tomas
T
Kvedaras
Vytautas
V
Strupas
Kestutis
K
Poskus
Eligijus
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000473:pathology; D001005:Anus Neoplasms / Q000473:pathology / Q000601:surgery*; D003106:Colon / Q000473:pathology; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008097:Lithuania; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009367:Neoplasm Staging; D011183:Postoperative Complications; D016032:Randomized Controlled Trials as Topic; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000473:pathology; D012086:Reoperation; D013997:Time Factors