Lower leg compartment syndrome following laparoscopic uterine malignancy surgery for uterine cancer complicated by rheumatoid arthritis: a case report and literature review

Abstract

Background: Compartment syndrome is a condition in which an increased internal pressure in the upper/lower leg compartment results in circulatory disturbance causing muscle and nerve dysfunction. There have been five case reports of compartment syndrome following gynecologic laparoscopic surgery. We present this rare case herein with a review of the related literature. Case: The patient was a 44-year-old woman. She underwent laparoscopic modified radical hysterectomy for uterine cancer. During surgery, she wore elastic stockings from her toes to her knees. She also had intermittent pneumatic compression of the thighs and lower legs with the head down at 15 degrees. The operative time was 6 h and 49 min. She was diagnosed with compartment syndrome, and a decompression incision was indicated. Conclusion: After experiencing this case, we use the open leg position, releasing the high pelvic position for 10 min every 3 h, during which the nurse should decompress the foot. prolonged surgeries in the lithotomy position have become more common. There are many reports of WLCS cases after colorectal cancer surgery, which are also performed for the pelvis in the lithotomy position [8]. However, to the best of our knowledge, there have been only five case reports of WLCS following gynecologic laparoscopic surgery including our report [9–12]. The present case is of a laparoscopic modified radical hysterectomy performed for uterine cancer. The surgery was prolonged in the lithotomy position causing postoperative compartment syndrome for which fasciotomy was performed.