History

History of the Lithuanian Society of Coloprocotology (1991-2011) - brochure

Development of Coloproctology in Lithuania

The treatment of large intestine and perineum diseases in Lithuania has rather deep traditions. Theory and practice of those diseases have been studied and developed in the old Vilnius University, in the interwar period in the Independent Lithuania, and in the post-war period as well as after the re-establishment of Lithuania’s independence.

The professional training of medical specialists in Lithuania was started in 1781, following the establishment of the Faculty of Medicine at the Vilnius Academy. Simultaneously, first knowledge about the treatment of proctologic patients came forth. Professor J. Frankas in his book “Practical Medical Advice” described the causes of the rectal cancer, its spreading, course, treatment and consequences. A list of operations performed by the University Surgery Clinic Professor K. Porcijanka and his disciples also contains operations on “fistula ani”. Four dissertations were defended at the University on the topic of proctology. The first dissertation in 1812 was defended by M. Galenzovskis (Mathias Galenzowski, lithvanus, “De Haemorrhoidibus in genere, et praecipue de cura haemrrhoidum coecarum”). Here the causes of the hemorrhoid, especially its treatment, are considered. A.Abicht in his dissertation of 1816 (Adolphus Abicht, erlangensis, “De intestinorum coartatione diarrhoeae chronicae causa minus vulgata”) writes about chronic diarrhea, caused by the intestinal stricture. J. Heltzl in 1827 wrote a dissertation about anal fistulas, their classification and the methods of ligature treatment (Josephus Heltzl, volhyniensis, “De ani fistula”). A dissertation-monograph by H. Javlovskis (Hieronymus Jawlowski, lithuanus, “De carcinomate intestini recti”) on the rectal cancer was published in 1842, describing thereof the amputation of the rectum in the case of cancer, performed by J. Korženevskis on July 13, 1840 at the Vilnius Surgery Academy. This is the first such operation performed not only in Lithuania, but also in the Russian Empire. It is notable that already in 1848 the first medical popular book, related to the large intestine pathology, was published in the Lithuanian language “Regulas del skarbavų žmoniu kayp sawi reyk užleykiti nuog choleras, ir kayp grytey ratawoti prastoms naminioms lekarstoms ley kokio sodo pasiroditu cholera.”

After the re-establishment of Lithuania’s statehood in 1918, a great deal of attention was devoted to the development of medicine. According to the accounting data of the Kaunas State Hospital published in 1925, 36 patients were treated for the large intestine diseases, of which 25 underwent operation. The then and later proctologic operations were also performed at the Kaunas Jewish Hospital, and B. Zacharinas, the head of the surgery department of that hospital, implemented operations, then popularized in Lithuania, for the treatment of rectal prolapse according to Kummel and Tiersch. Proctologic operations were performed in Ukmergė, Kėdainiai, Panevėžys county and other hospitals. In 1940, at the Seventh Congress of the Lithuanian Society of Surgeons, two works were announced on the topic of proctology – “Fissura ani Treatment with Dextrosis - Glycerine Injections” by V. Tumasonis and “Ambulatory Surgical Treatment of Hemorrhoids” by J. Žemgulys (Dr. Juozas Žemgulys was killed brutally on the first days of the Germany-USSR war).

In the postwar years, proctology as a separate field of medicine was not developed. It became of interest from the beginning of the seventh decade (at the faculty surgery clinic of the Kaunas Medicine University, etc.). The proctologic subdivisions were set up in Kaunas (Kaunas Second Clinical Hospital) and in Vilnius (Vilnius City University Hospital), complicated operations were performed. Two dissertations for the habilitated doctor degree (P. Norkūnas and V. Zykas) and several doctor’s dissertations (D. Pavalkis, A. Tamelis, Ž. Saladžinskas et al.) in this field were prepared. Coloproctology, however, as a separate specialized subject was not developed. Patients with surgery diseases of the large intestine and perineum were treated in the surgery departments, and their treatment was not always optimum. Only patients with large intestine cancer were most often treated in the oncology outpatient clinics and other establishments of that profile.

After the reestablishment of an independent Lithuania, specialized medical societies started to be created. Having perceived the importance of specialized surgery for science and practice, a group of Lithuanian enthusiastic surgeons – V. Zykas, R. Keblas, D. Pavalkis, Ž. Saladžinskas, R. Žiugžda, A. Tamelis, Pr. Jonauskas and others, possessing the accumulated sufficient experience in the diagnosis and treatment of coloproctologic diseases, on November 28, 1991 in Kaunas called the constituent meeting of the Lithuanian Society of Proctologists (LSP) and established the Lithuanian Society of Proctologists, elected its Board and President – Professor V. Zykas. On April 2, 1992, the Articles of Association of the Society were registered with the Ministry of Justice of Lithuania. Among the most important tasks of the LSP – propagation of knowledge in coloproctology science, sharing clinical experience, and theoretical improvement. With an aim of tackling the said tasks, LSP conferences, congresses, seminars and symposia were organized.

The first conference of Lithuanian proctologists took place on September 23-24, 1993 in Kaunas. The issues discussed at the conference covered operative treatment of hemorrhoids; treatment of complicated anal fistulas and results; pathophysiology, diagnosis and treatment of fecal incontinence; the application of suturing apparatus in the large intestine surgery; supportive treatment of the tumours of the rectum and colon; surgery of cancer of the rectum and colon; surgery training of large intestine diseases, etc. The participants of the conference learnt on the development of proctology and its prospects in Lithuania. The Articles of Association of the Lithuanian Society of Proctologists (LSP) were discussed and approved at the conference. The conference proceedings were published in the journal “Medicina” (1993, No. 8). The conference, in addition to the well-known Lithuanian surgeons, proctologists, oncologists, and children’s surgeons, was attended with reports by the surgeons from other countries – Prof. G. Ekelund from Sweden, Prof. L. Kronberger from Austria, Prof. S. Navruzov from Uzbekistan, Prof. Shafik and Prof. O. El-Sibai from Egypt, Dr. med. R. Bergamaschi from France, P. Buffatti from Italy, P. Lunniss from England, H. Sabiers from Germany, M. Szczepkowski from Poland. In fact, the first LSP congress may be called international.

Following three years, on May 19-21, 1996, in Vilnius, the Second Conference of Lithuanian Coloproctologists “Surgery of the Large Intestine” was held. At this conference the newest problems of coloproctology – supervision and surgery of the stoma, experience of the first laparoscopic surgery of the large intestine in Lithuania, and practice of restorative colectomies in the treatment of familial adenomatous polyposis and non-specific ulcerative colitis were discussed. Also other important issues of coloproctology, namely, treatment of the large intestine tumours and complications caused, were considered. Prof. G. Ekelund from the Malmö University Hospital reported on the treatment of non-specific ulcerative colitis. The conference was also attended by Prof. M.-C. Marti, the Secretary General of the European Council of Coloproctologists (ECCP). He reported to the conference participants on the history of the European Council of Coloproctologists, its present activities and future plans. Of interest was a report by Prof. M.-C. Marti on the ambulatory proctosurgery . Surgeons from Poland and Belarus also took part at the conference. The conference proceedings were published in the journal “Medicina” (1996, No. 5). At this conference, the Articles of Association of the Society were supplemented and somewhat amended. A decision was made to change the name of the Lithuanian Society of Proctologists (LSP) by the Lithuanian Society of Coloproctologists (LSC). The New Articles of Association were registered with the Ministry of Justice on November 20, 1996 by Order No. 543-V.

The Third Congress of Lithuanian Coloproctologists was held on September 23-24, 1999 in Panevėžys. Here the scientific and practical achievements in the treatment of the cancer of the large intestine and complications caused, the surgical treatment of large intestine cancer metastasis in the liver were discussed. Diagnosis and treatment of hemorrhage from the lower part of the digestive tract in adults and children, issues of ambulatory and the so-called small proctology were discussed. Other urgent issues in coloproctology were also considered, like the treatment of anal fistula and acute paraproctitis and abscesses of the channels of sacral and coccygeal areas, comparative data of resistance of the large intestine sutures to the internal pressure of the bowels, the aspects of surgical treatment of chronic constipation of children, etc. A guest from the Czech Republic, Prof. T. Skrička, President of the Czech Society of Coloproctologists, presented new data on the complicated cancer of the large intestine, possibilities of the treatment of hemorrhoids, and examination of biological formations by means of electronic microscopy. The hosts of the congress delivered an interesting report on the development of the Panevėžys Hospital within 80 years and the important practical activities of the specialists in coloproctology in the course of the past years. The congress proceedings were published in the journal “A Lithuanian Physician of General Practice” (1999, No.5).

The Fourth Congress of Lithuanian Coloproctologists took place on May 9-10, 2002 in Klaipėda (Giruliai). Important scientific and practical achievements in the surgery of the large intestine and perineum as well as the further development of the Society’s activity were discussed at the Congress. Experience was shared as regards the diagnosis and treatment of the large intestine tumours in the Lithuanian and Danish medical establishments, the large intestine diverticulosis, its complications and treatment, and approach to the surgical treatment of chronic colostasis in adults. Issues related to the surgery of acute perineum diseases and rehabilitation of patients with trauma and stoma were considered in detail, new methods of treatment were discussed. R. Šiugžda provided exhaustive and very valuable study data on the large intestine suture healing peculiarities during the experiment from theoretical and practical viewpoint. The congress was attended and reports were delivered by the outstanding scientists from Denmark S. Bulow, H. Harling, S. Segel, T. Jurgensen, and H.J. Nielsen. At the organizing meeting, Dr. R. Keblas, Vice-President of the LSC, authorized by the meeting, presented Prof. V. Zykas with an honorary diploma, where it was said that Dr. habil. Prof. Vytautas Zykas, its founder and first long-term President, was awarded with the title of the LSC Honorary President for his considerable contribution to the development of the LSC activities. A new LSC Board was elected. Dr. Narimantas Evaldas Samalavičius was elected President of the new LSC Board (See the book: Surgery of the Large Intestine and Perineum, Kaunas, 2002.)

The Fifth Congress of Lithuanian Coloproctologists was held on May 5-6, 2005 in Vilnius. Lithuania’s integration to the European Union, the still more rapid flow of information and the necessity of its exchange attracted to the congress numerous guests from overseas: Denmark, Sweden, Finland, Germany, Great Britain, Hungary, Slovakia, and Russia. The congress was attended not only by coloproctologists and surgeons of other profiles, but also by gastroenterologists, radiologists, rehabitologists, and specialists of other fields of medicine. This made it possible to discuss a broad spectrum of issues related to the large intestine and perineum pathology: diagnosis, treatment, rehabilitation, treatment results and coloproctology innovations. The comprehensive clinical studies in cooperation of coloproctologists with gastroenterologists, radiologists and morphologists were presented. Thus, from the first to the last LSC congress, all of them by their organization and contents have become not only the national but also international events. This is the common merit of all surgeons and coloproctologists who perceived the importance of that speciality and the result of their long-term and purposeful work (see: The Fifth Congress of Lithuanian Coloproctologists. LIETUVOS CHIRURGIJA. Lithuanian Surgery, 2005, 3(2), P. 137-155).

On April 24-25, 2008, in Vilnius, the Sixth Congress of Lithuanian Coloproctologists took place. A tradition has been formed that preparation of the LSC congresses was conducted in cooperation with the institutions of higher education – KMU, VU Faculty of Medicine, other scientific and medical institutions and societies. They are attended by a wide spectrum of doctors from Lithuania and abroad. This congress is extraordinary since here for the first time a special meeting of the only International Society of Coloproctologists of the University was organized, and the well-known professors even from three continents – Europe, America and Asia – delivered their reports. The programme of the congress reflected three trends of the issues under discussion – the urgent issues of the treatment of the cancer of the large intestine, complications in the treatment of the large intestine and anal diseases, and innovations in the diagnosis and treatment of the large intestine and anal diseases. The character of reports is diverse – this includes the demonstration of clinical cases, discussion of the newest treatment cases, analysis of respective anamneses, or analysis of the data of the group of treatment establishments. In the report “Laparoscopic Surgery of the Malignant Diseases of the Large Intestine and Anus in Lithuania 2005 – 2008”, the results of 130 laparoscopic operations of 7 treatment institutions were discussed and conclusions were drawn. Foreign guests: Professor Indru T. Khubchandani (USA), Seung-Kook Sohn (South Korea), Eloy Espin Basny (Spain), Parvez Sheikh (India), Kemal Deen (Sri Lanka), and Steffen Bulow (Denmark) delivered very interesting reports on the newest achievements of coloproctology in the field of diagnosis and treatment, implemented in various clinics of the country, enriched our knowledge and approach to the future prospects (See: The Sixth Congress of Lithuanian Coloproctologists. LIETUVOS CHIRURGIJA. Lithuanian Surgery, 2008, 6(1), P. 76-93).

In addition to congresses and major LSC scientific events, other important, international scientific events were organized in Kaunas and Vilnius, hosting numerous members of the society and doctors, interested in coloproctology. As Prof. N.E. Samalavičius, the LSC President, noted, in our country gradually the “tripole” is being formed – the attractive events at last started to be also organized in Klaipėda. Alongside the old traditions, lately, a new manner of communication appeared – the so-called Consensus meetings, two of which took place in Druskininkai. The international recognition of our coloproctologists is witnessed by the fact that the LCD was admitted to that organization at the Fifth Congress of the European Council of Coloproctologists (ECCP) on 1995.06.14 in Barcelona. In the congresses of the society and other events, quite a number of conspicuous foreign coloproctologists participate and deliver reports, and at the Sixth LSC Congress, the International Society of Coloproctologists of the University organized a special meeting. The international events of coloproctology were made diversified by the days of Mayo Clinic in Lithuania, especially the visits of the outstanding personalities in coloproctology – Prof. Stanley M. Goldberg from the USA and John Nicholls from the United Kingdom, demonstration operations and lectures by the legendary English Professor R.J. Heald. A still greater number of the members of our society join the ranks of international societies of coloproctologists, some of them are included into the boards of those societies.

Much has been done in practical, everyday coloproctology. The qualified assistance of coloproctologists is provided in the Kaunas and Vilnius clinics, Klaipėda, Šiauliai, Panevėžys and other hospitals. Here various and complicated operations on the large intestine and perineum are performed. In many outpatient clinics and other specialized rooms a qualified assistance is provided, ambulatory coloproctology operations were performed. The Lithuanian Society of Coloproctologists itself becomes consolidated, the number of its members and activity increases. The activity of the society becomes more intensive not only inside the country, i.e. communicating with other societies, but it also still more gets inflowed into the international organizations of coloproctologists and maintains constantly close contacts with a number of the coloproctology centres, with many well-known coloproctologists abroad.

Quite a lot of time passed from the constituent meeting of the Lithuanian Society of Coloproctologists in 1991, which took place immediately after the reestablishment of Independence. At that time a young society has covered a long and fruitful road, it has become one of the most active societies of surgical profile in our country. The material and technical basis of the subdivisions of coloproctology became consolidated, their network got expanded.

I, together with the LSC Board and its President, would like to wish all the members of our Society the great achievements in developing our field, which is not an easy one, precise and timely diagnoses, successful modern treatment, good health, creative joy and colleague communication and cooperation.

Prof. Dr. habil Vytautas Zykas

Honorary President of the Lithuanian Society of Coloproctologists

Kaunas, December 19, 2008

ADDITIONAL INFORMATION...

Habilitated doctor degrees, habilitation procedures and doctoral degrees in a field of coloproctology

Nr	Name, surname	Title	Type of thesis	Year
1	Petras Norkūnas	Data on the diagnosis, treatment and prophylaxis of rectal cancer	Habilitation	1969
2	Vytautas Zykas	Diagnostic and prognostic system for surgical and multidisciplinary treatment of rectal cancer	Habilitation	1985
3	Dainius Pavalkis	Analysis of diagnostic methods of colorectal cancer, prognosis and evaluation of the results of treatment	Habilitation procedure	2006
4	Narimantas Evaldas Samalavičius	Optimization of the surgical treatment of colorectal disorders	Habilitation procedure	2006
5	Antanas Norveišis	Comparison of the treatment of haemorrhoids with novocaine-alcohol block versus complex method	PhD	1978
6	Dainius Pavalkis	Rehabilitation of patients with loop and side colostomies	PhD	1990
7	Arvydas Burneckis	Combined gama-neutron radiotherapy for carcinoma of the rectum	PhD	1993
8	Žilvinas Saladžinskas	The diagnosis and treatment of anal sphincter and distal rectum motoric insufficiency	PhD	1994
9	Algimantas Tamelis	The importance of anal anatomical changes to the treatment of haemorrhoids	PhD	1995
10	Pavel Elsakov	Early colonoscopic diagnosis of colorectal cancer	PhD	1995
11	Robertas Bagdzevičius	Differential diagnosis of constipation in children and indications for surgical treatment	PhD	1997
12	Narimantas Evaldas Samalavičius	Familial adenomatous polyposis and its treatment in Lithuania	PhD	1999
13	Giedrė Rudinskaitė	Comparative study of patients undergoing rectal resection and abdominoperineal resection	PhD	2004
14	Rasa Jančiauskienė	Evaluation of efficacy of chemotherapy in the cancer of colon and rectum	PhD	2006
15	Eligijus Poškus	Optimization of the one-stage surgical treatment of left-sided colonic cancer	PhD	2007
16	Valdemaras Jotautas	Modification and results of transanal endoscopic microsurgery	PhD	2007
17	Tomas Poškus	Comparative study of treatment methods of haemorrhoids	PhD	2008
18	Saulius Švagždys	Rectal adenocarcinoma: prognostic value of angiogenesis and matrix metalloproteinases MMP-2, MMP-9 and their inhibitors TIMP-2, TIMP-3	PhD	2009
19	Tadas Latkauskas	Evaluation of the results of surgical treatment of patients with stage II and III rectal cancer after preoperative radiotherapy and preoperative radiochemotherapy	PhD	2010
20	Audrius Dulskas	Changes in anorectal and urogenital function in patients undergoing radical surgery for rectal cancer	PhD	2016