Nakai Chie, Kawata Kei, Nagai Shingo, Kubota Yasuaki
The Department of Urology, Toyota Memorial Hospital.
Hinyokika Kiyo. 2018 Dec;64(12):497-500. doi: 10.14989/ActaUrolJap_64_12_497.
Well leg compartment syndrome (WLCS) is an uncommon and severe complication that occurs after prolonged surgery in the lithotomy position. A 67-year-old male with bladder cancer who underwent cystectomy including ileal conduit construction in the lithotomy position developed severe, gradually worsening cramping pain in the right leg on the day after surgery. The posterior compartmental pressure of the right leg was high (40 mmHg), and WLCS was diagnosed. Emergency fasciotomy was followed by rehabilitation for one month and he recovered from motor or sensory deficits, but the pain continued. We considered that important factors associated with the development of WLCS in this patient were arteriosclerosis obliterans and the length of time during which he remained in the lithotomy position during the ileal conduit procedure. We consider thatlengthy surgical procedures for cystectomy with patients in the lithotomy position have high potential for inducing WLCS.
下肢筋膜室综合征（WLCS）是一种在长时间截石位手术后发生的罕见且严重的并发症。一名67岁的膀胱癌男性患者，在截石位下行膀胱切除术，包括回肠代膀胱术，术后第二天出现右下肢严重且逐渐加重的痉挛性疼痛。右下肢后筋膜室压力较高（40 mmHg），诊断为WLCS。紧急行筋膜切开术，随后进行了一个月的康复治疗，患者运动或感觉功能缺损得以恢复，但疼痛仍持续存在。我们认为，该患者发生WLCS的重要相关因素是闭塞性动脉硬化以及在回肠代膀胱术过程中处于截石位的时间长度。我们认为，对处于截石位的患者进行长时间的膀胱切除手术有很高的诱发WLCS的可能性。
