Well-leg compartment syndrome after laparoscopic low anterior resection for lower rectal cancer in the lithotomy position: A case report.

Publisher: Wiley Blackwell Country of Publication: Japan NLM ID: 101506753 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1758-5910 (Electronic) Linking ISSN: 17585902 NLM ISO Abbreviation: Asian J Endosc Surg Subsets: MEDLINE

Original Publication: Japan : Wiley Blackwell

Anterior Compartment Syndrome/*etiology ; Anterior Compartment Syndrome/*surgery ; Laparoscopy/*adverse effects ; Patient Positioning/*adverse effects ; Rectal Neoplasms/*surgery; Anterior Compartment Syndrome/physiopathology ; Decompression, Surgical/methods ; Fasciotomy/methods ; Humans ; Laparoscopy/methods ; Male ; Middle Aged ; Postoperative Complications/diagnosis ; Postoperative Complications/surgery ; Proctoscopy/methods ; Prognosis ; Rectal Neoplasms/pathology ; Supine Position ; Treatment Outcome ; Wound Healing/physiology

A 64-year-old man underwent laparoscopic low anterior resection for lower rectal cancer. Because he was overweight (BMI, 28.1 kg/m ² ) with rich visceral fat and a narrow pelvic cavity, the operation was technically difficult and the operation time was 686 min. Postoperatively, the patient immediately complained of pain and swelling of the left lower limb. Laboratory examination showed that serum creatinine kinase was markedly increased and urine myoglobin was positive on postoperative day 1. He was diagnosed with well-leg compartment syndrome and was transported to the trauma and critical care center for emergency fasciotomy. After initial treatment, he was transferred to our hospital on postoperative day 7. He completely recovered after 2 months. Although well-leg compartment syndrome is rare, it is necessary to consider it as a potential complication when performing a long colorectal cancer surgery with the patient in the lithotomy position, particularly when laparoscopic surgery is planned.
(© 2017 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.)

Keywords: Colorectal cancer; compartment syndrome; laparoscopic surgery

Date Created: 20170706 Date Completed: 20180912 Latest Revision: 20180912

20240829

10.1111/ases.12410

28677871