Vecchio Michele, Santamato Andrea, Geneovese Fortunato, Malaguarnera Giulia, Catania Vito Emanuele, Latteri Saverio
Physical Medicine and Rehabilitation, A.O.U. Policlinico Vittorio Emanuele, University of Catania, Italy.
Department of Physical Medicine and Rehabilitation-"OORR Hospital", University of Foggia, Italy.
Ann Med Surg (Lond). 2018 Mar 1;28:34-37. doi: 10.1016/j.amsu.2018.02.002. eCollection 2018 Apr.
Peripheral neuropathy after surgical treatment is an under recognized potential untoward event. Pelvic surgery may be associated with nerve lesions by essentially three main mechanisms: transection, entrapment and pressure-stretching; the latter is the modality most frequently linked to patient's positioning on the operating room table.
A 25 years old woman, after undergoing a laparoscopic gynaecologic procedure lasted >3 hours, on postoperative day one presented with numbness over her lateral right leg and dorsum of the foot, right foot drop and gait instability due to compression-stretching of the right superficial peroneal nerve.
Patient's diagnostic work up, treatment and outcome are reported and measures on how to prevent the occurrence of such type of lesion are outlined together with the importance of an early postoperative diagnosis in order to avoid permanent nerve damage.
Such lesions are sometimes so unexpected that delayed diagnosis leads to damages which are difficult or impossible to repair. Primary prevention plays a key role and it is realized by adhering to specific protocols. In the occurrence of the lesion a prompt diagnosis is highly recommendable and a comprehensive therapeutic plan is necessary to correctly address the specific pathology.
手术治疗后的周围神经病变是一种未得到充分认识的潜在不良事件。盆腔手术可能通过三种主要机制与神经损伤相关：横断、卡压和压力拉伸；后者是与患者在手术台上的体位最常相关的方式。
一名25岁女性，在接受了一场持续超过3小时的腹腔镜妇科手术后，术后第一天出现右小腿外侧和足背麻木、右足下垂以及因右腓浅神经受压拉伸导致的步态不稳。
报告了患者的诊断检查、治疗及结果，并概述了如何预防此类损伤的发生的措施，以及术后早期诊断对于避免永久性神经损伤的重要性。
此类损伤有时非常意外，以至于延迟诊断会导致难以修复或无法修复的损害。一级预防起着关键作用，通过遵守特定方案来实现。在损伤发生时，强烈建议进行及时诊断，并且需要一个全面的治疗计划来正确处理特定的病理情况。
