Lower limb compartment syndrome as a complication of robot-assisted radical prostatectomy: the UK experience

Abstract

Objective: To evaluate the incidence of lower limb compartment syndrome (LLCS) in robot-assisted radical prostatectomy (RARP) and the prevalence of risk factors in patients with LLCS.

Methods: Data were collected from 17 UK robotic surgery institutions for a multicentre analysis. Data were used to calculate the incidence of LLCS and the prevalence of risk factors.

Results: A total of 3110 RARPs were performed by 17 institutions between 2004 and 2011. There were nine cases of LLCS, giving an incidence of 0.29%. Seven of these required fasciotomy. The prevalence of risk factors was as follows: console time >4 h in 8/9 cases, early learning curve (<20 cases) in 3/9 cases; obesity (BMI >30 kg/m(2) ) in 5/9 cases; and peripheral vascular disease in 2/9 cases. One patient with LLCS was positioned incorrectly.

Conclusions: The serious complication LLCS occurs in RARP but has a low incidence. Long operating times, surgical inexperience, poor patient positioning, obesity and vascular disease appear to be risk factors.

Keywords: compartment syndrome; complication; prostate cancer; prostatectomy; robot.