Takech Kaoru, Inoue Kazuyoshi, Suzuki Masami, Kawanishi Hiroyuki, Onishi Ai, Hirasaki Akihito
Masui. 2017 Apr;66(4):434-437.
We report a case of well leg compartment syndrome (WLCS) in both legs after robot-assisted laparoscopic prostatectomy (RALP). A 65-year-old man underwent surgery for prostate cancer. He was placed in the lithotomy position and both his legs were protected with elastic stockings and intermittent pneumatic com- pression to prevent deep vein thrombosis during sur- gery. After surgery, he complained of pain in both calves. Movement and sensory disorder along with swelling were found in both legs. Computed tomogra- phy of the legs showed damage to the soleus and gas- trocnemius muscles of both legs. The creatinine phos- phokinase level had increased to 10,560 IU · l⁻¹. The patient was diagnosed with WLCS in both legs and underwent conservative treatment. Symptoms in both legs started to improve from the next day. The right leg swelling receded within 10 days, while the left leg swelling receded 67 days after surgery. WLCS in the legs after RALP is a rare but severe complication requiring early diagnosis and intervention. To prevent WLCS, it is important that we recognize this disease as a potential complication after RALP.
我们报告了一例机器人辅助腹腔镜前列腺切除术后双侧下肢发生的健康肢体骨筋膜室综合征(WLCS)。一名65岁男性因前列腺癌接受手术。术中他处于截石位,双腿使用弹力袜并进行间歇性充气加压以预防深静脉血栓形成。术后,他主诉双侧小腿疼痛。双下肢出现活动及感觉障碍并伴有肿胀。腿部计算机断层扫描显示双侧比目鱼肌和腓肠肌受损。肌酸磷酸激酶水平升至10,560 IU·l⁻¹。该患者被诊断为双侧下肢WLCS并接受了保守治疗。从第二天起双下肢症状开始改善。右腿肿胀在10天内消退,而左腿肿胀在术后67天消退。RALP术后下肢WLCS是一种罕见但严重的并发症,需要早期诊断和干预。为预防WLCS,重要的是我们要认识到这种疾病是RALP术后的一种潜在并发症。