The John Goligher Colorectal Unit, Leeds General Infirmary, Leeds, UK.
Colorectal Dis. 2011 May;13(5):494-9. doi: 10.1111/j.1463-1318.2009.02172.x.
In spite of recent advances in technology and technique, laparoscopic colorectal surgery is associated with increased operating times when compared with open surgery. This increases the risk of acute lower limb compartment syndrome. The aim of this review was to gain a better understanding of postoperative lower limb compartment syndrome following laparoscopic colorectal surgery and to suggest strategies to avoid its occurrence.
A MEDLINE search was performed using the keywords 'compartment syndrome', 'laparoscopic surgery' and 'Lloyd-Davies position' between 1970 and 2008. All relevant articles were retrieved and reviewed.
A total of 54 articles were retrieved. Of the 30 articles in English, five were reviews, six were original articles and 19 were case reports, of which only one was following laparoscopic colorectal surgery. The remaining 24 were non-English articles. Of these, two were reviews and 22 were case reports, of which only one was following laparoscopic colorectal surgery. The incidence of acute compartment syndrome following laparoscopic colorectal surgery is unknown. The following are believed to be risk factors for acute lower limb compartment syndrome: the Lloyd-Davies operating position with exaggerated Trendelenburg tilt, prolonged operative times and improper patient positioning. Simple strategies are suggested to reduce its occurrence.
Simple preventative measures have been identified which may help to reduce the incidence of acute lower limb compartment syndrome. However, if suspected, timely surgical intervention with four-compartment fasciotomy remains the standard of care.
尽管技术和技术有了最近的进展，但与开放手术相比，腹腔镜结直肠手术的操作时间增加。这增加了急性下肢间隔综合征的风险。本综述的目的是更好地了解腹腔镜结直肠手术后下肢间隔综合征，并提出避免其发生的策略。
使用 1970 年至 2008 年间的关键词“间隔综合征”、“腹腔镜手术”和“劳埃德-戴维斯位置”在 MEDLINE 上进行了搜索。检索并回顾了所有相关文章。
共检索到 54 篇文章。在 30 篇英文文章中，有 5 篇是综述，6 篇是原始文章，19 篇是病例报告，其中只有 1 篇是腹腔镜结直肠手术后的报告。其余 24 篇是非英文文章。其中，有 2 篇是综述，22 篇是病例报告，其中只有 1 篇是腹腔镜结直肠手术后的报告。腹腔镜结直肠手术后急性间隔综合征的发生率尚不清楚。据信，急性下肢间隔综合征的危险因素包括劳埃德-戴维斯手术体位、过度特伦德伦伯格倾斜、手术时间延长和不当的患者体位。建议采取简单的策略来降低其发生的可能性。
已经确定了一些简单的预防措施，可能有助于降低急性下肢间隔综合征的发生率。然而，如果怀疑存在这种情况，及时进行四间隔筋膜切开术的手术干预仍然是标准的治疗方法。
