Masataka Fukuda1, Izumi Kawagoe2, Tsukasa Kochiyama1, Nozomi Ando1, Osamu Kudoh1, Daizoh Satoh1, Masakazu Hayashida1. 1. Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan. 2. Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan. ikawago@juntendo.ac.jp.
Abstract
BACKGROUND: The indications for robot-assisted urologic surgeries have expanded due to their low invasiveness. However, complicated surgical procedures lead to prolonged surgical duration, requiring patients to remain in the lithotomy position for an extended time. Well leg compartment syndrome (WLCS) is a known severe postoperative complication related to the lithotomy position. CASE PRESENTATION: We report a case of WLCS after robot-assisted radical cystectomy (RARC), in which the patient recovered without neurological sequelae. A 55-year-old, obese male who underwent RARC complained of right leg pain and paresthesia 3 h after the surgery that lasted for 481 min. Emergency evaluation revealed unilateral WLCS in the anterior and lateral compartments. Urgent fasciotomy was performed 4 h after symptom onset. He thereafter recovered completely and was discharged without any neuromuscular dysfunction. CONCLUSIONS: Early detection of WLCS, surgical treatment, and additional measures are crucial to prevent its life-threatening and/or disabling outcomes.
BACKGROUND: The indications for robot-assisted urologic surgeries have expanded due to their low invasiveness. However, complicated surgical procedures lead to prolonged surgical duration, requiring patients to remain in the lithotomy position for an extended time. Well leg compartment syndrome (WLCS) is a known severe postoperative complication related to the lithotomy position. CASE PRESENTATION: We report a case of WLCS after robot-assisted radical cystectomy (RARC), in which the patient recovered without neurological sequelae. A 55-year-old, obese male who underwent RARC complained of right leg pain and paresthesia 3 h after the surgery that lasted for 481 min. Emergency evaluation revealed unilateral WLCS in the anterior and lateral compartments. Urgent fasciotomy was performed 4 h after symptom onset. He thereafter recovered completely and was discharged without any neuromuscular dysfunction. CONCLUSIONS: Early detection of WLCS, surgical treatment, and additional measures are crucial to prevent its life-threatening and/or disabling outcomes.
Entities:
Keywords:
Fasciotomy; Lithotomy position; Robot-assisted radical cystectomy; Well leg compartment syndrome
Authors: M Menon; A K Hemal; A Tewari; A Shrivastava; A M Shoma; N A El-Tabey; A Shaaban; H Abol-Enein; M A Ghoneim Journal: BJU Int Date: 2003-08 Impact factor: 5.588