Dos Reis José Maciel Caldas, Queiroz Lauro José Mendes, Mello Pablo Ferreira, Teixeira Renan Kleber Costa, Gonçalves Fábio de Azevedo
Faculdade Metropolitana da Amazônia - FAMAZ, Belém, PA, Brasil.
Hospital do Coração - HCOR, Belém, PA, Brasil.
J Vasc Bras. 2019 Apr 17;18:e20180117. doi: 10.1590/1677-5449.180117. eCollection 2019.
Acute compartment syndrome of the lower extremities after urological surgery in the lithotomy position is a rare but potentially devastating clinical and medicolegal problem. We report the case of a 67-year-old male who underwent laparoscopic prostatectomy surgery to treat cancer, spending 180 minutes in surgery. Postoperatively, the patient developed acute compartment syndrome of both legs, needing emergency bilateral four-compartment fasciotomies, with repeated returns to the operating room for second-look procedures. The patient also exhibited delayed wound closure. He regained full function within 6 months, returning to unimpaired baseline activity levels. This report aims to highlight the importance of preoperative awareness of this severe complication which, in conjunction with early recognition and immediate surgical management, may mitigate long-term adverse sequelae and improve postoperative outcomes.
泌尿外科手术采用截石位后发生的下肢急性骨筋膜室综合征是一个罕见但可能具有毁灭性的临床和法医学问题。我们报告一例67岁男性患者，他接受了腹腔镜前列腺癌切除术，手术时间为180分钟。术后，患者双下肢发生急性骨筋膜室综合征，需要紧急进行双侧四室筋膜切开术，并多次返回手术室进行二次探查手术。患者还出现了伤口延迟愈合。他在6个月内恢复了全部功能，恢复到未受损的基线活动水平。本报告旨在强调术前认识到这种严重并发症的重要性，这种并发症与早期识别和立即手术处理相结合，可能会减轻长期不良后遗症并改善术后结果。
