Compartimental Syndrome After Laparoscopic Partial Nephrectomy
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v83i2.857Keywords:
Well-leg compartment syndrome , nephrectomy , lateral decubitus positionAbstract
Case report: 73-year-old male who is diagnosed with a right renal tumor undergoes a laparoscopic partial nephrectomy which, due to complication controlling the vascular pedicle, turns into an open surgery. After 48 hours, the patient develops a left gluteal compartment syndrome (pain, paresis and edema in lower limb) and rhabdomyolysis (CK 50000Ul/l) . The diagnosis was mainly clinical. Abdominal-pelvic CT showed volume increase and edema at the gluteal muscle level. Due to high clinical suspicion, urgent decompressive fasciotomy in the area is required (48h post-nephrectomy). 48 and 96 hours after this urgent surgery, the fasciotomy wound was reviewed in the operating room, debriding and cleaning the affected tissues exhaustively. Finally, vacuum assisted closure is applied to enhance the healing of the tissues.
Relevance and clinical implications: The aim of our study is to present a case of compartment syndrome after a laparoscopic partial nephrectomy that converted to open surgery, a complication thathas not been previously described in medical literature.
Conclusions: Compartment syndrome is a very infrequent post-surgical complication but potentially life-threatening, can also occurs after nephrectomies in patients placed in lateral decubitus. Clinical suspicion is fundamental in patients with risk factors and compatible symptoms, and should be treated early to reduce the sequelae and the high morbidity associated with it.
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