Survey of compartment syndrome of the lower extremity after gynecological operations
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- 作者：Emanuel C. A. Bauer (1)
Nicolina Koch (2)
Christoph J. Erichsen (3)
Tobias Juettner (4)
Daniel Rein (5)
Wolfgang Janni (1)
Hans G. Bender (2)
Markus C. Fleisch (2) - 关键词：Compartment syndrome ; Gynecological surgery ; Incidence ; Prevention ; Lithotomy position
- 刊名：Langenbeck's Archives of Surgery
- 出版年：2014
- 出版时间：March 2014
- 年：2014
- 卷：399
- 期：3
- 页码：343-348
- 全文大小：167 KB
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Nicolina Koch (2)
Christoph J. Erichsen (3)
Tobias Juettner (4)
Daniel Rein (5)
Wolfgang Janni (1)
Hans G. Bender (2)
Markus C. Fleisch (2)
1. Department of Obstetrics and Gynecology, Ulm University, Ulm, Germany
2. Department of Obstetrics and Gynecology, Heinrich Heine University, Moorenstr. 5, 40225, Duesseldorf, Germany
3. Department of Traumatology and Orthopedics, Trauma Center Murnau, Murnau, Germany
4. Department of Anaesthesiology, Heinrich Heine University, Duesseldorf, Germany
5. Department of Obstetrics and Gynecology, St. Elisabeth Hospital, Cologne, Germany - ISSN：1435-2451
文摘
Purpose This study was aimed to investigate incidence, circumstances and consequences of acute compartment syndrome (CS) of the lower extremity after gynecological operations in lithotomy position by collecting data from departments of Obstetrics and Gynecology in Germany. Design Retrospective observational study. Setting Departments of Obstetrics and Gynecology in the area of North Rhine (Germany) Methods A 24-item questionnaire was sent to 168 gynecological departments. In addition, cases anonymously reported to the Expert Committee for Medical Malpractice Claims of the Medical Association of North Rhine between 2002 and 2012 were analyzed. Main outcome measure Incidence of acute CS after gynecological operations. Results A total of 59 questionnaires (35?%) were returned for analysis, reporting 21 cases of CS. Based on the collected data, we calculated an incidence of postoperative CS ranging between 0.067?% and 0.28?%. All reported cases of postoperative CS occurred after surgeries in lithotomy position, 57.1?% of cases occurred after laparoscopic procedures and 76.2?% after procedures longer than 4?h. Overall, 61.0?% of departments do not routinely inform about the risk of this complication when they get patients-informed consent. Reported prevention strategies were inconsistent and ranged from none to multiple measures. Conclusion CS is a complication clearly associated with long lasting gynecological operations in Lithotomy position. Despite a relatively high incidence, so far no guidelines on perioperative management and medicolegal aspects exist and preventive measures are heterogeneous among institutions. The need for guidelines and recommendations by an expert committee has been identified.