Mohamedahmed Ali Yasen, Narayanasamy Sangara, Agrawal Dakshita, Mohamedahmed Marwa Yassin, Fadul Ashraf, Ramasamy Sadhasivam, Husain Najam, Thomas Pradeep
General Surgery, Queen's Hospital Burton, University Hospitals of Derby and Burton NHS Trust, Burton-on-Trent, GBR.
Critical Care Medicine, Atbara Teaching Hospital, Atbara, SDN.
Cureus. 2024 Aug 27;16(8):e67886. doi: 10.7759/cureus.67886. eCollection 2024 Aug.
Well-leg compartment syndrome is a rare and severe complication that occurs after prolonged surgery in the lithotomy position. This review outlines the presentation, diagnosis, and management of well-leg compartment syndrome after colorectal surgery. A comprehensive and systematic search of various electronic databases was conducted. All case reports and case series of well-leg compartment syndrome after colorectal surgery were included. Patient demographics, operative details, presenting symptoms, investigations, management, and treatment outcomes were collected from the eligible reports. Twenty-three articles, reporting a total of 36 patients, were eligible for inclusion in this review. Most of the included patients were male (88.9%), with an age range of 7-74 years. All reported cases in this review were placed in lithotomy position variations (standard lithotomy, Lloyd-Davies, and modified lithotomy) with an operative time exceeding four hours. Moreover, the presenting symptoms were lower limb pain, swelling, and loss of sensation on postoperative days 0 and 1. Fasciotomy was performed in 88.9% of cases, and half of the patients developed permanent sensory or motor dysfunction in the lower limbs. In conclusion, well-leg compartment syndrome is a rare, devastating complication that may result in permanent sensory or motor dysfunction. Early diagnosis and management are paramount for preserving limb function and optimising patient outcomes.
健侧下肢骨筋膜室综合征是一种罕见且严重的并发症，发生于长时间截石位手术后。本综述概述了结直肠手术后健侧下肢骨筋膜室综合征的表现、诊断及处理。我们对各种电子数据库进行了全面系统的检索。纳入了所有结直肠手术后健侧下肢骨筋膜室综合征的病例报告和病例系列。从符合条件的报告中收集了患者人口统计学资料、手术细节、出现的症状、检查、处理及治疗结果。23篇文章共报告了36例患者，符合纳入本综述的条件。纳入的患者大多数为男性（88.9%），年龄范围为7至74岁。本综述中所有报告的病例均采用了截石位的不同变体（标准截石位、劳埃德 - 戴维斯位和改良截石位），手术时间超过4小时。此外，出现的症状为术后第0天和第1天下肢疼痛、肿胀及感觉丧失。88.9%的病例进行了筋膜切开术，半数患者出现下肢永久性感觉或运动功能障碍。总之，健侧下肢骨筋膜室综合征是一种罕见且严重的并发症，可能导致永久性感觉或运动功能障碍。早期诊断和处理对于保留肢体功能及优化患者预后至关重要。
