Department of Surgery, East Lancashire NHS Trust, Blackburn, UK.
Department of Vascular Surgery, Swansea Bay University Health Board, Swansea, UK.
Br J Surg. 2019 Aug;106(9):1156-1166. doi: 10.1002/bjs.11177.
Patients undergoing prolonged pelvic surgery may develop compartment syndrome of one or both lower limbs in the absence of direct trauma or pre-existing vascular disease (well leg compartment syndrome). This condition may have devastating consequences for postoperative recovery, including loss of life or limb, and irreversible disability.
These guidelines represent the collaboration of a multidisciplinary group of colorectal, vascular and orthopaedic surgeons, acting on behalf of their specialty associations in the UK and Ireland. A systematic analysis of the available peer-reviewed literature was undertaken to provide an evidence base from which these guidelines were developed.
These guidelines encompass the risk factors (both patient- and procedure-related), diagnosis and management of the condition. Key recommendations for the adoption of perioperative strategies to facilitate prevention and effective treatment of well leg compartment syndrome are presented.
All surgeons who carry out abdominopelvic surgical procedures should be aware of well leg compartment syndrome, and instigate policies within their own institution to reduce the risk of this potentially life-changing complication.
接受长时间盆腔手术的患者可能会在没有直接创伤或预先存在的血管疾病(无症状肢体间隔综合征)的情况下出现单侧或双侧下肢间隔综合征。这种情况可能对术后恢复产生毁灭性的后果,包括生命或肢体的丧失,以及不可逆转的残疾。
这些指南代表了英国和爱尔兰的多学科结直肠、血管和骨科外科医生团队的合作,代表其专业协会采取行动。对现有同行评议文献进行了系统分析,为制定这些指南提供了证据基础。
这些指南涵盖了该疾病的危险因素(包括患者和手术相关因素)、诊断和治疗。提出了采用围手术期策略的关键建议,以促进无症状肢体间隔综合征的预防和有效治疗。
所有进行腹盆腔手术的外科医生都应该了解无症状肢体间隔综合征,并在其所在机构制定政策,以降低这种可能改变生活的并发症的风险。