Lower Limb (Well Leg) Compartment Syndrome After Urological Pelvic Surgery

Abstract

Because the lithotomy position is one of the most common positions used in urology, it is mandatory for urologists to be familiar with the complications associated with it. If this complication is recognized early, prompt treatment decreases morbidity and mortality. Minimizing the risk of WLCS will leave urologists less open to litigation, which may follow this significant iatrogenic complication.

Factores de riesgo combinados para síndrome compartimental de la pierna después de una prostatectomía radical laparoscópica

“…El cuadro clínico está caracterizado por un dolor en aumento de la pierna desproporcionado en relación con los resultados clí-nicos y la inflamación en la pantorrilla 5 . De forma frecuente, se encuentra parestesia del pie, rigidez articular en el tobillo y dolor ante estiramiento muscular pasivo 1 .…”

“…Se requiere un alto índice de sospecha clínica para el diagnóstico temprano de SC 5 , que es frecuentemente mal diagnosticado como TVP, celulitis o neuropraxia, particularmente en casos menos graves o si los síntomas son unilaterales. Las consecuencias de un diagnóstico errado o demorado son devastadoras para el paciente, ya que lleva a rabdomiólisis, fallo renal agudo, acidosis metabólica y arritmias cardíacas 1,5,6 .…”

Risk factors for the development of well leg compartment syndrome after sex reassignment surgery in patients with gender identity disorder

“…1 Although there are several considerable complications of SRS carried out in the lithotomy position, well leg compartment syndrome (WLCS) is one of the severe complications that require emergency attention, such as immediate fasciotomy. [2][3][4] However, the incidence and risk factors for WLCS in GID patients who undergo SRS remain unknown. We evaluated risk factors for development of WLCS, as well as determinants of elevation of creatinine phosphokinase (CK) after SRS for patients with GID.…”

“…The intraoperative position change is recommended by Raza et al 1 As the authors mentioned, there are no reports that investigate the development of WLCS after sex reassignment surgery (SRS) for gender identity disorder patients. 2 General urologists are not so familiar with SRS. However, the frequency of this operation will gradually increase in the future.…”

Well leg compartment syndrome following prolonged surgery in the supine position

“…if WLCS is not detected and treated early, it may lead to rhabdomyolysis and its consequences, i.e., myoglobinuric renal failure, multiorgan failure, or irreversible nerve deficits and longterm neuromuscular deficits of the lower limb. 5 Our hospital has removed the latex covered heel pads used in this case and has instituted the widespread use of pressure reliving mattresses for longer procedures. A high index of circumspection is necessary in the postoperative period, as the early signs of WLCS may be subtle.…”