Massimiliano Lia1, Julia Caroline Radosa2, Shadi Younes1, Andreas Fiehn3, Thomas Buerger4, Anke Mothes5, Bahriye Aktas1, Marc Philipp Radosa6. 1. Department of Gynecology, University Hospital, Leipzig, Germany. 2. Department of Gynecology, Saarland University Hospital Saarland, Homburg, Germany. 3. Department of Anesthiology, Agaplesion Diakonie Hospital, Kassel, Germany. 4. Department of Vascular Surgery, Agaplesion Diakonie Hospital, Kassel, Germany. 5. Department of Gynecology, St Georg Hospital, Eisenach, Germany. 6. Department of Gynecology, University Hospital, Leipzig, Germany. marc.radosa@medizin.uni-leipzig.de.
Abstract
PURPOSE: The postoperative non-traumatic compartment syndrome (PNCS) is a rare, but serious postoperative complication. Etiology, risk factors and clinical manifestation of PNCS are not well characterized since data in gynecologic and obstetric patients are limited. METHODS: We performed a retrospective monocentric study of patients who underwent surgery for gynecologic or obstetrics conditions and identified five cases of PNCS, which were analyzed and compared to a control cohort in regard of incidence, clinical presentation, risk factors and clinical outcome. RESULTS: Five cases of PNCS were identified among 19.432 patients treated between 2008 and 2019 with an incidence rate of 0.026%. The clinical examination was shown to be unreliable, lacking sensitivity in most clinical signs. Young age, obesity and long operation time were risk factors for the development of a PNCS. Fasciotomy for the treatment of a PNCS should not be delayed, since permanent function loss may occur early. CONCLUSION: A low threshold of clinical suspicion might be prudent to identify PNCS following gynecologic surgery. In the presence of the described risk factors, any suspicion of a PNCS should be evaluated further and if necessary treated with fasciotomy urgently.
PURPOSE: The postoperative non-traumatic compartment syndrome (PNCS) is a rare, but serious postoperative complication. Etiology, risk factors and clinical manifestation of PNCS are not well characterized since data in gynecologic and obstetricpatients are limited. METHODS: We performed a retrospective monocentric study of patients who underwent surgery for gynecologic or obstetrics conditions and identified five cases of PNCS, which were analyzed and compared to a control cohort in regard of incidence, clinical presentation, risk factors and clinical outcome. RESULTS: Five cases of PNCS were identified among 19.432 patients treated between 2008 and 2019 with an incidence rate of 0.026%. The clinical examination was shown to be unreliable, lacking sensitivity in most clinical signs. Young age, obesity and long operation time were risk factors for the development of a PNCS. Fasciotomy for the treatment of a PNCS should not be delayed, since permanent function loss may occur early. CONCLUSION: A low threshold of clinical suspicion might be prudent to identify PNCS following gynecologic surgery. In the presence of the described risk factors, any suspicion of a PNCS should be evaluated further and if necessary treated with fasciotomy urgently.
Authors: Babak Shadgan; Matthew Menon; David Sanders; Gregg Berry; Claude Martin; Paul Duffy; David Stephen; Peter J O'Brien Journal: Can J Surg Date: 2010-10 Impact factor: 2.089