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Review
. 2024 Aug 27;16(8):e67886.
doi: 10.7759/cureus.67886. eCollection 2024 Aug.

Lessons to Learn From 36 Cases of Well-Leg Compartment Syndrome in Colorectal Surgery: A Systematic Literature Review

Ali Yasen Mohamedahmed  1 , Sangara Narayanasamy  1 , Dakshita Agrawal  1 , Marwa Yassin Mohamedahmed  2 , Ashraf Fadul  3 , Sadhasivam Ramasamy  1 , Najam Husain  4 , Pradeep Thomas  4
Affiliations
Review

Lessons to Learn From 36 Cases of Well-Leg Compartment Syndrome in Colorectal Surgery: A Systematic Literature Review

Ali Yasen Mohamedahmed et al. Cureus. .

Abstract

Well-leg compartment syndrome is a rare and severe complication that occurs after prolonged surgery in the lithotomy position. This review outlines the presentation, diagnosis, and management of well-leg compartment syndrome after colorectal surgery. A comprehensive and systematic search of various electronic databases was conducted. All case reports and case series of well-leg compartment syndrome after colorectal surgery were included. Patient demographics, operative details, presenting symptoms, investigations, management, and treatment outcomes were collected from the eligible reports. Twenty-three articles, reporting a total of 36 patients, were eligible for inclusion in this review. Most of the included patients were male (88.9%), with an age range of 7-74 years. All reported cases in this review were placed in lithotomy position variations (standard lithotomy, Lloyd-Davies, and modified lithotomy) with an operative time exceeding four hours. Moreover, the presenting symptoms were lower limb pain, swelling, and loss of sensation on postoperative days 0 and 1. Fasciotomy was performed in 88.9% of cases, and half of the patients developed permanent sensory or motor dysfunction in the lower limbs. In conclusion, well-leg compartment syndrome is a rare, devastating complication that may result in permanent sensory or motor dysfunction. Early diagnosis and management are paramount for preserving limb function and optimising patient outcomes.

Keywords: colorectal surgery; fasciotomy; lithotomy position; lloyd-davies position; well-leg compartment syndrome.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. The PRISMA flowchart
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; WLCS: well-leg compartment syndrome
Figure 2
Figure 2. Algorithm demonstrating practical steps for the prevention, diagnosis, and management of WLCS.
WLCS: well-leg compartment syndrome. Image Credits: Ali Yasen Mohamedahmed, Najam Husain, and Pradeep Thomas
See this image and copyright information in PMC

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